Orencia® (abatacept)

Orencia (abatacept) is covered only for FDA‑approved uses—adult moderate‑to‑severe RA, adult PsA, polyarticular JIA (age ≥2), and prophylaxis of acute aGVHD in HSCT recipients age ≥2 when given with a calcineurin inhibitor and methotrexate—off‑label uses are excluded. Coverage requires indication‑specific prior therapy (e.g., RA: 3‑month trial of ≥1 biologic or a conventional DMARD), appropriate prescriber specialty (rheumatologist for RA/JIA, dermatologist/rheumatologist for PsA, oncologist/hematologist/transplant physician for GVHD), documentation of age/weight and donor type (matched or 1‑allele‑mismatched unrelated donor for GVHD), and limits approval to 30 days/4 doses initially for GVHD and 12 months for other indications with reauthorization requiring ≥6 months on therapy and objective or symptomatic improvement.

"Treatment of adult patients with moderately to severely active rheumatoid arthritis."