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The Policy VaultThe Policy Vault

Bimzelx (bimekizumab-bkzx)Point32Health

Non-radiographic axial spondyloarthritis

Preferred products

  • Cimzia
  • Rinvoq
  • Taltz

Initial criteria

  • Documented diagnosis of non-radiographic axial spondyloarthritis
  • Patient age ≥ 18 years
  • Prescribed by or in consultation with a rheumatologist
  • Documentation of one (1) of the following: c. Both of the following: i. One (1) of the following: 1. Inadequate response or adverse reaction to one (1), or contraindication to all prescription strength non-steroidal anti-inflammatory drug (e.g., celecoxib, diclofenac, ibuprofen, naproxen, meloxicam) OR 2. Previous treatment with a biologic agent indicated for the requested use AND ii. Trial and failure with two (2), or contraindication to all of the following: Cimzia, Rinvoq, Taltz OR d. The patient is new to the plan and stable on Bimzelx and the prescribing physician has documented that changing to a preferred product would result in adverse clinical outcomes