Zydelig — CareFirst (Caremark)
Relapsed or refractory small lymphocytic lymphoma (SLL)
Initial criteria
- Member has relapsed or refractory CLL/SLL
- Member has received prior therapy with Bruton tyrosine kinase (BTKi) inhibitor (e.g., Brukinsa, Calquence) and venetoclax-based regimens
- Requested drug will be used as a single agent or in combination with rituximab
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months