Kevzara — Medica
Juvenile Idiopathic Arthritis/Juvenile Rheumatoid Arthritis – Initial Therapy
Initial criteria
- Patient meets the standard Inflammatory Conditions – Kevzara Prior Authorization Policy criteria
- Patient has tried TWO of the following: a tocilizumab SC product (Actemra SC, Tyenne SC), Enbrel, an adalimumab product, Rinvoq/Rinvoq LQ, or Xeljanz [documentation required]; OR According to prescriber, patient has heart failure, previously treated lymphoproliferative disorder, previous serious infection, OR a demyelinating disorder
Approval duration
6 months