Orencia — CareFirst (Caremark)
immune checkpoint inhibitor-related toxicity (myocarditis with/without myositis)
Initial criteria
- Member has myocarditis due to immune checkpoint inhibitor therapy
- Any of the following: inadequate response to systemic corticosteroids; intolerance or contraindication to corticosteroids; concomitant myositis and medication used in combination with ruxolitinib
Approval duration
6 months