Rinvoq — Medical Mutual

Initial criteria

• Patient age ≥ 18 years
• Patient has objective signs of inflammation (elevated CRP OR sacroiliitis on MRI)
• Patient had a 3-month trial of ≥1 TNF inhibitor OR unable to tolerate 3-month trial
• Rinvoq prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy ≥ 6 months
• Patient experienced beneficial clinical response when assessed by ≥ 1 objective measure OR patient experienced symptom improvement, such as decreased pain or stiffness, or improved function/activities of daily living

Approval duration

initial 6 months; renewal 1 year