Skip to content
The Policy VaultThe Policy Vault

Simponi Aria (golimumab intravenous infusion – Janssen)Cigna

Ankylosing spondylitis

Initial criteria

  • Patient age > 18 years; AND
  • Medication prescribed by or in consultation with a rheumatologist

Reauthorization criteria

  • Patient established on therapy for ≥ 6 months; AND
  • Patient demonstrates beneficial clinical response from baseline by at least one objective measure OR improvement in at least one symptom (e.g., decreased pain or stiffness, improved function or activities of daily living)

Approval duration

initial 6 months; reauth 1 year