Retevmo (selpercatinib capsules and tablets - Eli Lilly) — Cigna
Histiocytic Neoplasm
Initial criteria
- Patient is age ≥ 18 years
- Patient meets ONE of the following (i, ii, or iii): i. Langerhans cell histiocytosis; OR ii. Erdheim-Chester disease; OR iii. Rosai-Dorfman disease
- Patient has a rearranged during transfection (RET) fusion
Approval duration
1 year