Simponi (golimumab) subcutaneous — Point32Health
Ankylosing Spondylitis
Preferred products
- Enbrel
Initial criteria
- Documented diagnosis of ankylosing spondylitis
- Patient 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 non-steroidal anti-inflammatory drug (e.g., celecoxib, diclofenac, ibuprofen, naproxen, meloxicam) OR contraindication to non-steroidal anti-inflammatory drugs OR previous treatment with a biologic agent indicated for the requested use OR the patient is new to the plan and has been stable on the requested agent prior to enrollment