Copiktra (duvelisib) — CareFirst (Caremark)

Initial criteria

• Member has relapsed or refractory disease after at least two prior therapies
• Member has received prior therapy with Bruton tyrosine kinase (BTKi) inhibitor (e.g., Brukinsa, Calquence) and venetoclax‑based regimens
• Requested drug is used as a single agent

Reauthorization criteria

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

Approval duration

12 months