Xalkori (crizotinib) — CareFirst (Caremark)
Anaplastic Large Cell Lymphoma (ALCL)
Initial criteria
- Used for initial palliative therapy or for treatment of relapsed or refractory ALK-positive ALCL as a single agent
Reauthorization criteria
- Authorization may be renewed when there is no evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months