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The Policy VaultThe Policy Vault

ImkeldiBlue Cross Blue Shield of Oklahoma

stage four advanced metastatic cancer or associated condition

Preferred products

  • imatinib tablets

Initial criteria

  • ONE of the following:
  • A. BOTH of the following:
  • 1. Diagnosis of stage four advanced metastatic cancer and requested agent used to treat cancer or an associated condition AND
  • 2. Use consistent with best practices supported by peer-reviewed evidence and FDA approval OR
  • B. Currently treated and stable on requested agent OR
  • C. Tried and had inadequate response to imatinib tablets OR
  • D. Imatinib tablets discontinued due to lack of efficacy, diminished effect, or adverse event OR
  • E. Intolerance or hypersensitivity to imatinib tablets not expected with requested agent OR
  • F. FDA labeled contraindication to imatinib tablets not expected with requested agent OR
  • G. Imatinib tablets expected to be ineffective, cause adherence barrier, worsen comorbidity, decrease function, or cause harm OR
  • H. Imatinib tablets not in best interest of patient OR
  • I. Patient tried another drug in same class or mechanism as imatinib tablets which was discontinued OR
  • J. Support for use of requested agent over imatinib tablets