Brukinsa (zanubrutinib) — CareFirst (Caremark)
Chronic lymphocytic leukemia (CLL)
Initial criteria
- Brukinsa will be used as a single agent OR
- Brukinsa will be used for treatment of histologic (Richter) transformation to diffuse large B-cell lymphoma in combination with tislelizumab.
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen.
Approval duration
12 months