Golimumab (Simponi Aria)

Covered only for FDA‑approved indications (adult moderate–severe RA, psoriatic arthritis, polyarticular JIA, adult ankylosing spondylitis); requests for non‑FDA uses are excluded. Key requirements: initial approval (3 months) requires indication‑specific prior therapy (RA: 3‑month trial of ≥1 biologic or ≥1 conventional synthetic DMARD; JIA: trial of one other agent or documentation of aggressive disease), prescription by or consultation with the appropriate specialist (rheumatologist, or rheumatologist/dermatologist for psoriatic arthritis), induction dosing at weeks 0 and 4 with maintenance no more often than every 8 weeks (adults up to 2 mg/kg IV; pediatrics up to 80 mg/m2 IV), and reauthorization (12 months) requires documented clinical response.

"Treatment of adult patients with moderately to severely active rheumatoid arthritis."

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