Novarel — CareFirst (Caremark)
Acute graft-versus-host disease (GVHD)
Initial criteria
- Member has steroid-refractory acute graft-versus-host disease.
- Either the requested medication will be taken in conjunction with systemic corticosteroids OR member has an intolerance or contraindication to systemic corticosteroids.
Reauthorization criteria
- Member continues to meet initial coverage criteria.
Approval duration
12 months