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Intron A (interferon alfa-2b) — CareFirst (Caremark)

Chronic myeloid leukemia (CML)

Initial criteria

  • Authorization may be granted for treatment of CML.

Reauthorization criteria

  • Authorization of 12 months may be granted for continued treatment when there is no evidence of unacceptable toxicity or disease progression while on the current regimen.

Approval duration

6 months