Simponi (golimumab) — United Healthcare
Psoriatic Arthritis
Initial criteria
- Diagnosis of active psoriatic arthritis
- Patient is not receiving Simponi in combination with another immunomodulator [e.g., Enbrel (etanercept), Cimzia (certolizumab), Orencia (abatacept), adalimumab, Stelara (ustekinumab), Skyrizi (risankizumab), Tremfya (guselkumab), Cosentyx (secukinumab), Taltz (ixekizumab), Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib), Otezla (apremilast)]
Reauthorization criteria
- Documentation of positive clinical response to Simponi therapy
- Patient is not receiving Simponi in combination with another immunomodulator [e.g., Enbrel (etanercept), Cimzia (certolizumab), Orencia (abatacept), adalimumab, Stelara (ustekinumab), Skyrizi (risankizumab), Tremfya (guselkumab), Cosentyx (secukinumab), Taltz (ixekizumab), Xeljanz (tofacitinib), Olumiant (baricitinib), Rinvoq (upadacitinib), Otezla (apremilast)]
Approval duration
12 months