Rinvoq — Medical Mutual

Initial criteria

• Patient age ≥ 18 years
• 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 gastroenterologist

Reauthorization criteria

• Patient established on therapy ≥ 6 months
• Patient beneficial response when assessed by ≥ 1 objective measure OR symptom improvement (decreased pain, fatigue, stool frequency, rectal bleeding)

Approval duration

initial 6 months; renewal 1 year