Cimzia (certolizumab pegol) — Point32Health

Initial criteria

• Documented diagnosis of ankylosing spondylitis
• Patient is at least age ≥ 18 years
• Prescribed by or in consultation with a rheumatologist
• Documentation of one (1) of the following: inadequate response or adverse reaction to a prescription strength NSAID (e.g., celecoxib, diclofenac, ibuprofen, naproxen, meloxicam) OR contraindication to NSAIDs OR previous treatment with a biologic agent indicated for the requested use OR patient is new to the plan and has been stable on the requested agent prior to enrollment