Golimumab (Simponi Aria)

Coverage: intravenous golimumab (Simponi Aria) is covered for adults only for FDA‑approved indications—moderately to severely active rheumatoid arthritis, active psoriatic arthritis, and active ankylosing spondylitis—and excludes non‑FDA indications and pediatric use. Key requirements: initial RA authorization requires a 3‑month trial of ≥1 biologic OR ≥1 conventional synthetic DMARD, all indications require prescription by or consultation with a rheumatologist, dosing must follow 2 mg/kg IV at weeks 0 and 4 then every 8 weeks, initial approval is 3 months (renewal 12 months) with documented clinical response and compliance with applicable safety criteria.

"Adult patients with moderately to severely active rheumatoid arthritis (FDA-approved indication)."

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