Rydapt (midostaurin) — CareFirst (Caremark)
Symptomatic indolent systemic mastocytosis (ISM)
Initial criteria
- Rydapt is used as a single agent
- Member has received first-line therapy with a clinical trial or avapritinib
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months