adalimumab products — Medica

Initial criteria

• age > 2 years
• patient has tried at least one conventional therapy (e.g., systemic corticosteroid, immunosuppressant) OR has ophthalmic manifestations of Behcet’s disease
• medication is prescribed by or in consultation with a rheumatologist, dermatologist, ophthalmologist, gastroenterologist, or neurologist

Reauthorization criteria

• patient has been established on adalimumab therapy for ≥ 3 months
• when assessed by at least one objective measure, patient experienced a beneficial clinical response from baseline (e.g., best‑corrected visual acuity for ophthalmic disease, serum markers such as CRP or ESR, ulcer depth/number/size)
• compared with baseline, patient experienced symptom improvement such as decreased pain or improved visual acuity (if ophthalmic)

Approval duration

initial 3 months, reauth 1 year