Orencia (abatacept) Subcutaneous — Point32Health
Juvenile Idiopathic Arthritis
Preferred products
- Cimzia
- Enbrel
- Humira
- Rinvoq
- Xeljanz
Initial criteria
- Documented diagnosis of juvenile idiopathic arthritis
- Patient age ≥ 2 years
- Prescribed by or in consultation with a rheumatologist
- Documentation of one (1) of the following: (a) Both of the following: (i) Inadequate response or adverse reaction to one (1), or contraindication to all traditional disease modifying antirheumatic drug (e.g., methotrexate, leflunomide, hydroxychloroquine, sulfasalazine), or previous treatment with a biologic agent indicated for the requested use; (ii) Trial and failure with two (2) or contraindication to all of the following: Cimzia, Enbrel, Humira, Rinvoq, Xeljanz; OR (b) The patient is new to the plan and stable on Orencia and the prescribing physician has documented that changing to a preferred product would result in adverse clinical outcomes