Ojjaara (momelotinib tablets) — Cigna
Myelofibrosis (primary, post-polycythemia vera, or post-essential thrombocythemia)
Initial criteria
- Patient is age ≥ 18 years
- Patient meets ONE of the following (i, ii, or iii):
- i. Patient has higher-risk disease; OR
- ii. Patient meets BOTH of the following (a and b):
- a) Patient has lower-risk disease; AND
- b) Patient has at least one disease-related symptom (e.g., fatigue, fever, night sweats, weight loss, abdominal discomfort, splenomegaly, thrombocytosis, leukocytosis); OR
- iii. Patient has myelofibrosis-associated anemia
Approval duration
1 year