Afinitor Disperz — CareFirst (Caremark)
Central nervous system cancers (glioma including glioblastoma, meningioma, subependymal giant cell astrocytoma (SEGA))
Initial criteria
- Diagnosis of one of the listed CNS cancers
- Requested as single-agent or adjuvant therapy for SEGA
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on current regimen
Approval duration
12 months