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TyenneMedical Mutual

Systemic Juvenile Idiopathic Arthritis (SJIA)

Initial criteria

  • Patient has tried one other systemic therapy (e.g., corticosteroid, conventional DMARD, 1-month NSAID trial, or one biologic other than tocilizumab); AND
  • Medication is prescribed by or in consultation with a rheumatologist

Reauthorization criteria

  • Patient has been established on therapy for at least 6 months; AND
  • Patient experienced a beneficial clinical response assessed by objective measures OR patient experienced an improvement in at least one symptom compared with baseline

Approval duration

initial: 6 months; reauth: 1 year