Taltz — Medical Mutual

Initial criteria

• Patient is age > 18 years
• Patient has objective signs of inflammation, defined as at least one of the following: C-reactive protein elevated beyond upper limit of normal OR sacroiliitis reported on magnetic resonance imaging
• Prescribed by or in consultation with a rheumatologist

Reauthorization criteria

• Patient has been established on therapy for at least 6 months
• When assessed by at least one objective measure, patient experienced a beneficial clinical response from baseline OR compared with baseline patient experienced an improvement in at least one symptom such as decreased pain or stiffness, or improvement in function or activities of daily living

Approval duration

Initial: 6 months; Reauth: 1 year