Simponi Aria® (golimumab)
EVICORE-MEDICAL_DRUG-D96CBBD5
Simponi Aria (golimumab) is covered only for the listed FDA‑approved indications (moderately‑to‑severely active RA, psoriatic arthritis, polyarticular JIA, ankylosing spondylitis and related juvenile diagnoses) and is not covered for non‑FDA uses. Coverage requires indication‑specific prior therapy (e.g., RA initial: a 3‑month trial of another biologic or a conventional DMARD), specialist prescribing/consultation, documentation of weight/BSA and dosing, initial approval for 6 months, and reauthorization (12 months) requires ≥6 months on therapy with objective clinical benefit or documented symptom improvement.
"Adult patients with moderately to severely active rheumatoid arthritis"
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