support programs, we have your
patients covered
KEVZARA NATIONAL COVERAGE
KEVZARA is available nationally across multiple plans and segments.
PLAN NAME | KEVZARA COVERAGE STATUS | LIVES IMPACTED |
---|---|---|
Commercial | ||
BCBS FEP | Covered for use after failure on ONE of the following– Humira® or Enbrel® | 6 million |
CIGNA | Covered for use after failure on any TWO of the following– Humira®, Enbrel®, Rinvoq™, Xeljanz®, Actemra® | 6 million |
CVS (Advanced Control Specialty Formulary) | Preferred access: covered for first-line use following cDMARD | 16 million |
CVS Health (Aetna) | Preferred access: covered for first-line use following cDMARD | 2 million |
Elevance Health, Inc. | Covered for use after failure on TWO of the following- Enbrel®, Humira®, Rinvoq™, Simpon® | 7 million |
ESI | Covered for use after failure on any TWO of the following– Humira®, Enbrel®, Rinvoq™, Xeljanz®, Actemra® | 40 million |
Humana | Preferred access: covered for first-line use following cDMARD | 1 million |
Prime Clients | Covered for use after failure on any TWO of the following– Humira®, Enbrel®, Rinvoq™, Xeljanz®, Actemra® | 10 million |
Tricare | Covered for use after failure on Humira® | 9 million |
VA | Covered for use after failure on Enbrel® | 5 million |
Medicare | ||
CVS | Preferred access: covered for first-line use following cDMARD | 17 million |
ESI | Covered for use after failure on any TWO of the following– Humira®, Enbrel®, Rinvoq™, Xeljanz®, Actemra® | 1 million |
Humana | Preferred access: covered for first-line use following cDMARD | 8 million |
OptumRx PDP | Covered for use after failure of 2 preferred products Preferred products differ by state | 400,000 |
Managed Medicaid | ||
Anthem | Covered for use after failure on any TWO of the following– Enbrel®, Humira®, Rinvoq™, Simponi® | 3 million |
CVS | Preferred access: covered for first-line use following cDMARD | 15 million |
UHC Community | Covered for use after failure of 2 preferred products Preferred products differ by state | 9 million |
*Requires prior authorization.
Formulary data are provided by Managed Markets Insight Technology, LLC, and are current as of 01/23. Utilization management criteria shown represent CVS Caremark Rx’s Advanced Control Specialty Formulary (ACSF). According to these data, the ACSF makes up ~55% of CVS Caremark Rx’s commercially insured lives.
The vast majority of Commercial (81%) and Managed Medicaid (95%)
patients have access to KEVZARA after trying and failing with up to
2 products (double-step edit) or better.