Skip to content
The Policy VaultThe Policy Vault

RinvoqMedica

non-radiographic axial spondyloarthritis

Initial criteria

  • age ≥ 18 years
  • Objective signs of inflammation demonstrated by at least ONE of the following: a) elevated C-reactive protein (CRP) beyond the upper limit of normal; OR b) sacroiliitis reported on magnetic resonance imaging (MRI)
  • Patient meets ONE of the following: a) 3‑month trial of at least one tumor necrosis factor inhibitor; OR b) unable to tolerate a 3‑month trial of at least one tumor necrosis factor inhibitor
  • Medication prescribed by or in consultation with a rheumatologist

Reauthorization criteria

  • Patient has been established on therapy for at least 6 months
  • Patient meets ONE of the following: a) beneficial clinical response from baseline by objective measure (e.g., ASDAS, ASQoL, BASDAI, BASFI, BAS-G, BASMI, DFI, HAQ‑S, CRP, ESR); OR b) improvement from baseline in at least one symptom such as decreased pain or stiffness, or improved function or activities of daily living

Approval duration

initial 6 months; reauth 1 year