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imatinib mesylate — CareFirst (Caremark)

Myeloid/Lymphoid Neoplasms with Eosinophilia

Initial criteria

  • Diagnosis of myeloid and/or lymphoid neoplasms with eosinophilia and ABL1, FIP1L1::PDGFRA, or PDGFRB rearrangement in chronic phase or blast phase

Reauthorization criteria

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

Approval duration

12 months