Taltz (ixekizumab subcutaneous injection – Eli Lilly) — Cigna

Initial criteria

• Patient age > 18 years
• Patient has objective signs of inflammation defined as elevated C-reactive protein beyond the upper limit of normal OR sacroiliitis reported on magnetic resonance imaging
• 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 from baseline when assessed by at least one objective measure OR patient experienced improvement in at least one symptom such as decreased pain or stiffness or improvement in function or activities of daily living

Approval duration

initial 6 months; reauth 1 year