Pomalyst (pomalidomide capsules) — Cigna

Initial criteria

• Patient age ≥ 18 years
• Patient meets ONE of the following (i or ii): i. Patient is Human Immunodeficiency Virus (HIV)-negative; OR ii. Patient meets BOTH of the following (a and b): a) Patient is HIV-positive; AND b) Patient continues to receive highly active antiretroviral therapy

Approval duration

1 year