Rituximab (Rituxan, Ruxience, Truxima, Riabni)

Rituximab (Rituxan, Ruxience, Truxima, Riabni) is covered for specified non‑oncology indications—moderate‑to‑severe RA, GPA/MPA, pemphigus vulgaris, ITP, MS, NMO spectrum disorder, SLE, and GVHD—when used per the policy’s indication‑specific dosing and durations (oncology uses not covered here). Coverage requires documentation of the FDA‑approved or compendial diagnosis, prescribing/consultation by the appropriate specialist, required prior therapy trials (e.g., RA: ≥3 months of a biologic or a csDMARD; ITP: prior IVIG/steroids/splenectomy; MS: trial of ≥1 DMT), no prohibited concurrent biologic/targeted therapies, adherence to minimum intervals between courses (typically ≥16 weeks for RA/pemphigus/GPA and ≥6 months for ITP/MS), and evidence of clinical response for reauthorization.

"Moderately to severely active rheumatoid arthritis"

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