Vol. 5 No. 11 (2025)
Reimbursement Recommendations

Tofacitinib

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Published November 28, 2025

Key Messages

  • The Formulary Management Expert Committee (FMEC) recommends that tofacitinib be reimbursed for the treatment of patients with juvenile idiopathic arthritis (JIA) provided certain conditions are met.
  • Tofacitinib may be initiated for pediatric patients (between the age of 2 and below 18 years) for the treatment of JIA if all the following conditions are met. The patient must have a confirmed diagnosis of JIA, which includes the following subtypes: polyarticular course juvenile idiopathic arthritis (rheumatoid factor [RF]–positive polyarthritis, RF-negative polyarthritis, extended oligoarthritis, and systemic JIA without active systemic features), psoriatic arthritis, and enthesitis-related arthritis. The patient must also meet at least 1 of the following conditions related to methotrexate therapy: they have an inadequate response to methotrexate monotherapy at a maximum tolerated dose for at least 3 months; they have developed an intolerance to, or have a contraindication to, methotrexate therapy; or methotrexate is clinically inappropriate for the treatment of the patient’s condition. In addition, the patient must have had an inadequate response to a tumour necrosis factor (TNF) inhibitor or TNF inhibitor use is clinically inappropriate for the patient. Tofacitinib must also represent good value to the drug plans.