Arcalyst (rilonacept) — Medica

Initial criteria

• Patient is age ≥ 12 years
• Patient has recurrent pericarditis
• Prior to starting treatment with Arcalyst, patient had at least three episodes of pericarditis
• For the current episode, patient is receiving standard treatment (NSAIDs, colchicine, and/or systemic corticosteroids) OR standard treatment is contraindicated
• Medication is prescribed by or in consultation with a cardiologist or rheumatologist

Reauthorization criteria

• Patient has been established on this medication for at least 3 months
• When assessed by at least one objective measure, patient experienced a beneficial clinical response from baseline OR compared with baseline, patient experienced an improvement in at least one symptom

Approval duration

initial: 3 months; renewal: 1 year