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TasignaBlue Cross Blue Shield of Kansas

Philadelphia chromosome positive chronic myeloid leukemia (Ph+ CML) in chronic phase

Preferred products

  • imatinib (generic)
  • dasatinib (generic)

Initial criteria

  • Target Agent(s) will be approved when ALL of the following general PA criteria are met as above, including FDA or compendia-supported indication, treatment history, and preferred status.
  • If requested agent is Bosulif or Tasigna for CML, patient has been previously treated with Bosulif or Tasigna for CML.