adalimumab (preferred products) — Highmark
Rheumatoid Arthritis (RA)
Initial criteria
- age ≥ 18 years
- diagnosis of moderate to severe RA
- prescribed by or in consultation with a rheumatologist
- experienced therapeutic failure or intolerance to at least one non-biologic DMARD (for example, methotrexate, leflunomide, sulfasalazine, cyclosporine) OR all non-biologic DMARDs are contraindicated
Reauthorization criteria
- member has demonstrated disease stability or a beneficial response to therapy