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Imbruvica (ibrutinib tablets, capsules, and oral suspension)Cigna

B-Cell Lymphoma (e.g., diffuse large B-cell lymphoma, HIV-related B-cell lymphoma, post-transplant lymphoproliferative disorders, high-grade B-cell lymphoma)

Initial criteria

  • Patient is age ≥ 18 years
  • Patient has tried at least one systemic regimen

Approval duration

1 year