Abatacept is considered for payment in the following indications:
Adults with rheumatoid arthritis (RA) age 18 or older when the patient has had inadequate response after three months in treatment with any of the following:
a. Inhibitors of the tumor necrosis factor (etanercept, infliximab, adalimumab, antagonists of the receiver of Interleukin-1)
b. Non biological Disease modifying anti-rheumatic drugs (DMARDs) (methotrexate, sulfasalazine, hydroxychloroquine, leflunomide).
Moderate to severe Juvenile Idiopathic Arthritis (JIA) in children ≥ 2 years of age, as monotherapy or in combination with methotrexate
Active Psoriatic Arthritis (PsA)
Rheumatoid lung disease with rheumatoid arthritis
Rheumatoid arthritis with rheumatoid factor, unspecified
Juvenile dermatopolymyositis: Juvenile dermatomyositis, a rare but often severe and chronic systemic autoimmune disease, includes a large number of patients who are treatment resistant, requiring long term immunosuppressive therapy. A small open-label study published in Arthritis and Rheumatology shows promise using a targeted biologic therapy called abatacept to treat such patients.
Orencia may be considered investigational for all other ages and indications.