Ayvakit (avapritinib) — CareFirst (Caremark)
Advanced systemic mastocytosis (AdvSM)
Initial criteria
- Ayvakit will be used as a single agent
- Member’s platelet count is greater than or equal to 50 x 10^9/L
Reauthorization criteria
- For AdvSM, ASM, SM-AHN, MCL: No evidence of unacceptable toxicity or disease progression while on the current regimen
- For ISM: No evidence of unacceptable toxicity
Approval duration
12 months