Jaypirca (pirtobrutinib) — CareFirst (Caremark)

Initial criteria

• Requested as a single agent
• Member has previously tried BTK inhibitor and venetoclax-based regimens OR member has had resistance or intolerance to prior covalent BTK inhibitor therapy (e.g., acalabrutinib, zanubrutinib)

Reauthorization criteria

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

Approval duration

12 months