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The Policy VaultThe Policy Vault

Xeljanz XR (tofacitinib)Highmark

Psoriatic Arthritis

Preferred products

  • adalimumab product
  • Enbrel

Initial criteria

  • age ≥ 18 years
  • diagnosis of psoriatic arthritis
  • prescribed by or in consultation with a rheumatologist or dermatologist
  • experienced therapeutic failure or intolerance to a preferred adalimumab product or Enbrel for the treatment of psoriatic arthritis

Reauthorization criteria

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

Approval duration

12 months