Etanercept

Aetna covers Enbrel (etanercept) for specified inflammatory indications (e.g., rheumatoid arthritis, articular JIA ≥2 years, psoriatic arthritis ≥2 years, ankylosing spondylitis/axial SpA, plaque psoriasis ≥4 years, hidradenitis suppurativa, reactive arthritis, graft‑versus‑host disease, and other listed conditions) only when indication‑specific prior‑therapy, age, and response criteria are met (e.g., inadequate response to methotrexate/other DMARDs for RA/PsA/JIA, ≥2 NSAIDs for AS/axSpA, antibiotics for HS) and per dosing/quantity limits. Coverage requires a documented negative TB test within 6 months for biologic‑naive patients (do not treat active TB; treat latent TB before initiation) and prescription by or in consultation with specified specialists.

"Age restrictions: Articular JIA — members 2 years of age or older; Psoriatic arthritis — members 2 years of age or older; Plaque psoriasis — members 4 years of age or older (policy specifies these ..."