Enbrel (etanercept) — United Healthcare
Rheumatoid Arthritis
Initial criteria
- Diagnosis of moderately to severely active rheumatoid arthritis
- AND
- Patient is not receiving Enbrel in combination with another targeted immunomodulator [e.g., Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), adalimumab, Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib)]
Reauthorization criteria
- Documentation of positive clinical response to Enbrel therapy
- AND
- Patient is not receiving Enbrel in combination with another targeted immunomodulator [e.g., Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), adalimumab, Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib)]
Approval duration
12 months