Simponi (golimumab subcutaneous injection) — Cigna

Initial criteria

• Patient age ≥ 18 years
• Patient has tried one conventional synthetic DMARD for at least 3 months (methotrexate, leflunomide, hydroxychloroquine, or sulfasalazine)
• Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient experienced a beneficial clinical response when assessed by at least one objective measure OR experienced improvement in disease activity

Approval duration

initial 6 months; renewal 1 year