Turalio — CareFirst (Caremark)
Langerhans Cell Histiocytosis (LCH)
Initial criteria
- Used as a single agent.
- Member has a colony stimulating factor 1 receptor (CSF1R) mutation.
- Disease is symptomatic or relapsed/refractory.
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen.
Approval duration
12 months