Tyenne subcutaneous — Medica
Polyarticular Juvenile Idiopathic Arthritis – Initial Therapy
Preferred products
- Enbrel
- adalimumab-adbm
- Cyltezo
- adalimumab-adaz
- adalimumab-ryvk
- Simlandi
Initial criteria
- Patient meets the standard Inflammatory Conditions – Tocilizumab Subcutaneous Prior Authorization Policy criteria
- Patient has tried one adalimumab product (e.g., Humira, Abrilada, adalimumab-adaz, adalimumab-adbm, adalimumab-fkjp, adalimumab-aaty, adalimumab-ryvk, Simlandi, Amjevita, Cyltezo, Hadlima, Hulio, Hyrimoz, Idacio, Yuflyma, Yusimry) OR a trial of Enbrel, Cimzia, an infliximab product (e.g., Remicade, biosimilars), or Simponi Aria also counts OR According to the prescriber, patient has heart failure or a previously treated lymphoproliferative disorder
Approval duration
6 months