Rheumatoid arthritis (RA) is a complex and progressive disease that can affect functionality and quality of life. Early diagnosis and treatment of RA is critical to living a productive lifestyle. As reported by the Arthritis Foundation, current studies show that early and aggressive treatment of RA can limit joint damage, which can in turn reduce the chance for loss of movement, decreased ability to work, increased medical costs and potential need for surgery. It can even prevent long-term joint damage and disability.
Upon a positive RA diagnosis, please assess the benefits of prescribing disease-modifying anti-rheumatic drugs (DMARDs). Please note that the following DMARDs will require prior approval under the EmblemHealth Injectable Drug Utilization Program, which is managed by ICORE.*
Collaboration between a primary care physician and a rheumatologist can help ensure proper diagnosis of and care management for patients with RA. For more information, please consult our clinical practice guidelines for rheumatoid arthritis management, adopted from recognized sources.
* Members in the following plans are not part of our Injectable Drug Utilization Program and are exempt from prior approval for the above-mentioned injectable drugs: commercial plans underwritten by GHI (EmblemHealth EPO/PPO and GHI EPO/PPO); NY Bridge Plan (also underwritten by GHI); and HIP members assigned to a Montefiore (CMO) or Health Care Partners (HCP) PCP.