ceritinib — CareFirst (Caremark)

Initial criteria

• Used for treatment of ALK-positive IMT as a single agent
• Member has uterine sarcoma and the disease is advanced, recurrent, metastatic, or inoperable OR member has a soft tissue sarcoma (not including uterine sarcoma)

Reauthorization criteria

• No evidence of unacceptable toxicity or disease progression while on the current regimen

Approval duration

12 months