Sprycel — CareFirst (Caremark)

Initial criteria

• Disease is metastatic or unresectable
• Tumor has c-KIT activating mutations
• Requested medication will be used as subsequent therapy
• Member has had disease progression, intolerance, or risk of progression with BRAF-targeted therapy
• Requested medication will be used as single agent

Reauthorization criteria

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

Approval duration

12 months