etanercept products — Medica

Initial criteria

• age > 18 years
• Patient has tried one conventional synthetic DMARD for at least 3 months, unless patient previously tried a biologic other than the requested drug
• Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• Patient experienced a beneficial clinical response assessed by at least one objective measure OR patient experienced an improvement in at least one symptom (e.g., decreased joint pain, morning stiffness, or fatigue; improved function or activities of daily living; decreased soft tissue swelling in joints or tendon sheaths)

Approval duration

6 months initial, 1 year reauth