Rituximab (Rituxan, Ruxience, Truxima)

Rituximab (Rituxan/Ruxience/Truxima) is covered for specified non‑oncology indications — FDA‑approved RA, GPA, MPA, pemphigus vulgaris — and listed compendial off‑label uses (ITP, MS, NMO, SLE, GVHD); oncology uses are excluded. Coverage requires indication‑specific prior‑therapy trials (e.g., RA: 3 months of a biologic or csDMARD; ITP: prior IVIG/steroids/splenectomy; MS: failure/intolerance to ≥1 DMT), appropriate specialist prescribing/consultation, adherence to dosing/frequency limits (e.g., ≥16 weeks between courses for RA/GPA/MPA/pemphigus; ≥6 months for ITP/MS/SLE), and documentation of response/relapse for reauthorization.

"Moderately to severely active rheumatoid arthritis"

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