Ilaris — Medical Mutual
Familial Mediterranean Fever (FMF)
Initial criteria
- Patient age ≥ 2 years
- Tried colchicine unless contraindicated
- Will take Ilaris with colchicine unless contraindicated or not tolerated
- Prior to starting: C-reactive protein ≥ 10 mg/L OR ≥ 2x upper limit of normal AND patient has ≥ 1 flare/month despite colchicine OR was hospitalized for severe flare
- Prescribed by or in consultation with a rheumatologist, nephrologist, geneticist, gastroenterologist, oncologist, or hematologist
- Will not be used concurrently with other biologics
- Will not be used to treat rheumatoid arthritis
Reauthorization criteria
- Patient established on medication ≥ 6 months AND
- Beneficial clinical response by objective measure OR improved symptoms compared with baseline (e.g. decreased pain/tenderness, stiffness, swelling, fatigue, improved function or ADLs)
Approval duration
initial 6 months, reauth 1 year