Ilaris — Medical Mutual
Still's Disease, Adult Onset
Initial criteria
- Patient age ≥ 18 years
- Meets one of: (a) Tried ≥ 2 other biologics OR (b) Has features of poor prognosis AND tried Actemra or Kineret OR (c) Has concerns of progression to macrophage activation syndrome AND tried Kineret
- Prescribed by or in consultation with a rheumatologist
- 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 (e.g. resolution of fever, rash improvement, normalized markers, reduced steroid dose) OR improved symptoms (e.g. less joint pain/tenderness, stiffness, swelling, fatigue, improved function or ADLs)
Approval duration
initial 6 months, reauth 1 year