Simponi Aria® (golimumab)

Covered only for FDA‑approved indications — adult rheumatoid arthritis, psoriatic arthritis, adult ankylosing spondylitis, and polyarticular juvenile idiopathic arthritis (including juvenile spondyloarthropathy); non‑FDA uses are excluded. Key requirements: initial authorization (3 months; renewals 12 months) requires indication‑specific prior therapy and specialist prescribing/consultation (e.g., RA: 3‑month trial of a biologic or conventional DMARD and rheumatologist involvement; JIA: one prior agent or aggressive disease and rheumatology consult; PsA/AS: specialist prescribing), documented clinical response for reauthorization, and adherence to induction dosing (weeks 0 and 4) then maintenance no more frequently than every 8 weeks with specified age/weight dosing.

"Moderately to severely active rheumatoid arthritis in adults (FDA‑approved indication)."

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