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adalimumab (preferred products)Highmark

Psoriatic Arthritis (PsA) – enthesitis and/or dactylitis associated

Initial criteria

  • age ≥ 18 years
  • diagnosis of enthesitis and/or dactylitis associated with PsA
  • prescribed by or in consultation with a rheumatologist or dermatologist
  • experienced therapeutic failure or intolerance to at least one NSAID or a local glucocorticoid injection OR all NSAIDs and all local glucocorticoid injections are contraindicated

Reauthorization criteria

  • member has demonstrated disease stability or a beneficial response to therapy