Sharp Health Plan
Cimzia Prefilled (certolizumab pegol)
Drugs for Pain and Fever : Arthritis and Pain Drugs
  • Prior Authorization: Crohn's Disease (CD):
    Age Requirement: > 18
    Duration: 12 Month(s)

    Psoriatic Arthritis (PsA):
    Duration: 12 Month(s)

    Rheumatoid Arthritis (RA):
    PA Applies

  • Crohn's Disease (CD):
    Age Requirement: > 18
    Duration: 12 Month(s)
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    TB Test required: No

    Psoriatic Arthritis (PsA):
    Duration: 12 Month(s)
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    TB Test required: No

    Rheumatoid Arthritis (RA):
    Documented Diagnosis: No
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    TB Test required: No

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