Kevzara — Medical Mutual

Initial criteria

• Kevzara is prescribed by or in consultation with a rheumatologist
• The patient has tried ONE conventional synthetic DMARD for at least 3 months (e.g., methotrexate [oral or injectable], leflunomide, hydroxychloroquine, sulfasalazine) OR the patient has tried ONE biologic DMARD for at least 3 months

Reauthorization criteria

• Patient has had a response (e.g., less joint pain, morning stiffness, or fatigue; improved function or activities of daily living; decreased soft tissue swelling in joints or tendon sheaths; improved laboratories; reduced corticosteroid dosage), as determined by prescriber

Approval duration

initial 6 months, reauth 1 year