Simponi Aria (golimumab intravenous infusion – Janssen) — Cigna

Initial criteria

• Patient age > 2 years; AND
• Patient has tried at least one other medication for this condition (e.g., methotrexate, sulfasalazine, leflunomide, or NSAID) OR has aggressive disease as determined by prescriber; 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., improvement in motion, reduced joint pain, less morning stiffness or fatigue, or improved function or activities of daily living)

Approval duration

initial 6 months; reauth 1 year