Kineret

Drug - Kineret® (anakinra) [Biovitrum AB]

September 2019

Therapeutic area - Auto-inflammatory diseases

Approval criteria

• Patient has the diagnosis of Neonatal-Onset Multisystem Inflammatory Disease (NOMID) AND
• Patient has negative tuberculin test or, if positive, therapy with isoniazid was initiated at least 1 month prior to request AND
• Patient does not have an active infection or a history of recurring infections AND
• Patient is not taking tumor necrosis factor (TNF) inhibitors concomitantly

OR

• If the patient has the diagnosis of rheumatoid arthritis, refer to the PA criteria sheet, “Immunomodulators”

Quantity limit

• Patients with NOMID: 8 mg/kg/day 
• Patient’s most current body weight must be provided at time of request

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411