Rituximab (Rituxan)

Rituxan is covered for select non‑oncology indications—moderately to severely active RA (with required prior TNF/other therapy failure per criteria), GPA/MPA only with glucocorticoids, moderate–severe pemphigus vulgaris, and compendial use for refractory myasthenia gravis—oncology uses are excluded. Approvals require HBV screening, no severe active infection, no concurrent biologic therapy, documentation of indication‑specific prior therapy failures or disease severity, adherence to dosing/authorization limits (infusions ≥16 weeks apart, specified dosing schedules) and a 12‑month approval with evidence of improvement/stability for renewals where applicable.

"For myasthenia gravis: documentation that disease is refractory."

Sign up to see full coverage criteria, indications, and limitations.