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WeliregCareFirst (Caremark)

von Hippel-Lindau (VHL) disease associated with renal cell carcinoma, central nervous system hemangioblastomas, or pancreatic neuroendocrine tumors not requiring immediate surgery

Initial criteria

  • Diagnosis confirmed by genetic testing
  • Member does not require immediate surgery
  • Requested medication is being used to treat any of the following VHL-associated tumors: renal cell carcinoma (RCC) as a single agent, central nervous system (CNS) hemangioblastomas as a single agent, or pancreatic neuroendocrine tumors (pNET)

Reauthorization criteria

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

Approval duration

12 months