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ImkeldiCareFirst (Caremark)

Myeloid/Lymphoid Neoplasms with Eosinophilia

Preferred products

  • Gleevec
  • imatinib mesylate

Initial criteria

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

Reauthorization criteria

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

Approval duration

12 months