Augtyro (repotrectinib capsules) — Cigna
Pediatric diffuse high-grade gliomas (NTRK gene fusion-positive)
Initial criteria
- Patient is age < 18 years; AND
- Tumor is positive for neurotrophic receptor tyrosine kinase (NTRK) gene fusion; AND
- Patient meets ONE of the following (i or ii):
- i. Medication is used as adjuvant therapy; OR
- ii. Medication is used for recurrent or progressive disease
Approval duration
1 year