![]() Treatment of adults with moderate-to-severe plaque psoriasis (PSO) who are candidates for systemic therapy or phototherapy.Treatment of adults with active ankylosing spondylitis (AS).Treatment of adult patients with active psoriatic arthritis (PsA).Treatment of adults with moderately to severely active rheumatoid arthritis (RA).Reducing signs and symptoms of Crohn’s disease (CD) and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy.CIMZIA is not indicated for use in pediatric patients. Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, of which CIMZIA is a member. ![]() Patients should be closely monitored for the signs and symptoms of infection during and after treatment with CIMZIA. Serious and sometimes fatal side effects have been reported with CIMZIA, including tuberculosis (TB), bacterial sepsis, invasive fungal infections (such as histoplasmosis), and infections due to other opportunistic pathogens (such as Legionella or Listeria). LMN: letter of medical necessity PA: prior authorization PAP: Patient Assistance Program. The CIMplicity program may be amended or canceled at any time without notice. The CIMplicity program is provided as a service of UCB and is intended to support the appropriate use of CIMZIA. The parties reserve the right to amend or end this program at any time without notice. Claims should not be submitted to any public payor (ie, Medicare, Medicaid, Medigap, TRICARE, VA, and DoD) for reimbursement. Product dispensed pursuant to program rules and federal and state laws. Not valid for prescriptions that are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, similar federal- or state-funded programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), or where otherwise prohibited by law. UCB reserves the right to rescind, revoke, or amend this Program without notice.Īvailable to individuals with commercial prescription insurance coverage for a valid prescription of an FDA-approved indication for CIMZIA. To maintain eligibility in the program, the following are required: (1) a prior authorization request has been submitted and/or coverage remains unavailable for the patient and (2) if the prior authorization is denied by the payer, the prescriber must submit an appeal within the first sixty (60) days of the prior authorization denial and a prior authorization must be submitted every six (6) months thereafter or documentation as may otherwise be required by the payer. ![]() For initial enrollment into the program, the patient must be experiencing a delay in, or have been denied, coverage for CIMZIA by their commercial insurance plan. Program is not health insurance, nor is participation a guarantee of insurance coverage. Patients may be asked to reverify insurance coverage status during the course of the program. Program is not available to patients whose medications are reimbursed in whole or in part by Medicare, Medicaid, TRICARE, or any other federal or state program or where otherwise prohibited by law. Eligible patients with a valid prescription for CIMZIA can receive treatment with the CIMZIA Prefilled Syringe at no cost for up to two years or until the patient’s coverage is approved, whichever comes first. ![]()
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