Golimumab (Simponi Aria)
EVICORE-MEDICAL_DRUG-9616AFE2
Simponi Aria (golimumab) is covered for adults (≥18) for FDA‑approved indications—moderately to severely active rheumatoid arthritis, active psoriatic arthritis, and active ankylosing spondylitis—with 12‑month authorization and IV dosing 2 mg/kg at weeks 0 and 4 then every 8 weeks, and is excluded if the patient has an active infection or is receiving another biologic. Approval requires documented diagnosis and age, TB screening (and treatment if latent), documentation of prior treatment failures/intolerance per indication (e.g., prior biologic or targeted synthetic DMARD, or inadequate response to methotrexate/NSAIDs as specified), and evidence of improvement/stability for renewals.
"Documentation the individual does not have an active infection including localized infection"
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