Afinitor Disperz — CareFirst (Caremark)
Soft tissue sarcoma subtypes including perivascular epithelioid cell tumor (PEComa), recurrent angiomyolipoma, or recurrent lymphangioleiomyomatosis
Initial criteria
- Used as single agent therapy for locally advanced unresectable or metastatic disease
Reauthorization criteria
- Continuation may be approved when no unacceptable toxicity or disease progression
Approval duration
12 months