Rinvoq LQ — Cigna
Ankylosing Spondylitis
Preferred products
- Enbrel
- adalimumab-adbm
- Cyltezo
- adalimumab-adaz
- adalimumab-ryvk
- Simlandi
- Taltz
Initial criteria
- Patient meets the standard Inflammatory Conditions – Rinvoq/LQ Prior Authorization Policy criteria
- For Ankylosing Spondylitis: patient has tried ONE of Enbrel or an adalimumab product; OR
- For Crohn’s Disease: patient has tried ONE adalimumab product
Approval duration
6 months