Infliximab

Aetna covers infliximab products (Avsola, Inflectra, Remicade, Renflexis) for specified indications — e.g., Crohn’s disease and ulcerative colitis (age ≥6) and adult RA, AS/nr‑axSpA, PsA, plaque psoriasis, HS, and uveitis — but requires precertification and restricts higher‑cost brands (Remicade/Renflexis) to members with contraindication, intolerance, or failure of specified biosimilars/alternatives. Key requirements include RA use with methotrexate or leflunomide (or documented contraindication), biomarker/testing and a ≥3‑month methotrexate trial for biologic‑naïve RA, biologic‑naïve AS requires failure/intolerance to ≥2 NSAIDs, and usually one‑month trials of listed alternatives before approving Remicade/Renflexis.

"ICD-10 codes covered if selection criteria are met: H44."

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