Welireg — CareFirst (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