Kineret — Medical Mutual
Deficiency of Interleukin-1 Receptor Antagonist (DIRA)
Initial criteria
- DIRA is genetically confirmed by an FDA approved genetic test
- Kineret is prescribed by or in consultation with a rheumatologist, geneticist, or a physician who specializes in inflammatory conditions
- Site of care medical necessity is met
Reauthorization criteria
- Patient has had a response as determined by the prescriber
- Site of care medical necessity is met
Approval duration
initial 6 months; reauth 1 year