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The Policy VaultThe Policy Vault

Rinvoq LQCigna

Juvenile Idiopathic Arthritis – Initial Therapy

Preferred products

  • Enbrel
  • adalimumab-adbm
  • Cyltezo
  • adalimumab-adaz
  • adalimumab-ryvk
  • Simlandi

Initial criteria

  • Patient meets the standard Inflammatory Conditions – Rinvoq/LQ Prior Authorization Policy criteria; AND
  • Patient has tried one of Enbrel or an adalimumab product; OR a trial of Cimzia, an infliximab product (e.g., Remicade, biosimilars), or Simponi Aria also counts

Approval duration

6 months