Kineret (anakinra) — United Healthcare

Initial criteria

• Diagnosis of moderately to severely active rheumatoid arthritis
• Patient has had an inadequate response to one or more disease-modifying antirheumatic drugs (DMARDs) (e.g., methotrexate, leflunomide, and sulfasalazine)
• Patient is not receiving Kineret in combination with another targeted immunomodulator [e.g., Enbrel (etanercept), Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib)]

Reauthorization criteria

• Documentation of positive clinical response to Kineret therapy
• Patient is not receiving Kineret in combination with another targeted immunomodulator [e.g., Enbrel (etanercept), Cimzia (certolizumab), Simponi (golimumab), Orencia (abatacept), Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib)]

Approval duration

12 months