Kevzara — Point32Health

Initial criteria

• Documented diagnosis of polyarticular juvenile idiopathic arthritis
• Patient weight ≥ 63 kg
• Prescribed by or in consultation with a rheumatologist
• Documentation of one of the following: (a) Trial and failure of at least two of the listed medications from each of the following therapeutic categories (only one medication is required if only one is available for a listed therapeutic category): Interleukin Antagonists: Actemra; Janus Kinase Inhibitors: Rinvoq, Xeljanz; Selective T Cell Stimulators: Orencia; Tumor Necrosis Factors: Cimzia, Enbrel, Humira OR (b) Contraindication to all the following medications: Actemra, Rinvoq, Xeljanz, Orencia, Cimzia, Enbrel, and Humira