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adalimumab (preferred products)Highmark

Uveitis (UV)

Initial criteria

  • age ≥ 2 years
  • diagnosis of non-infectious intermediate, posterior or panuveitis
  • prescribed by or in consultation with an ophthalmologist
  • experienced therapeutic failure or intolerance to at least one immunosuppressant (for example, azathioprine, 6‑mercaptopurine) OR immunosuppressants are contraindicated

Reauthorization criteria

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