enasidenib — CareFirst (Caremark)
Acute Myeloid Leukemia (AML) with a susceptible IDH2 mutation (newly diagnosed, post-induction, or relapsed/refractory)
Initial criteria
- For treatment induction of newly diagnosed AML with a susceptible IDH2 mutation, all of the following must be met: requested medication will be used as a single agent or in combination with azacitidine AND member is not a candidate for or declines intensive induction therapy
- For post-induction therapy for AML with a susceptible IDH2 mutation, all of the following must be met: requested medication will be used as a single agent or in combination with azacitidine AND member has experienced response to Idhifa therapy
- For treatment as a single agent of relapsed or refractory AML with a susceptible IDH2 mutation
Reauthorization criteria
- Continuation of therapy may be granted when there is no evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months