Sprycel (dasatinib tablets - Bristol-Myers Squibb; generic) — Cigna
Acute Lymphoblastic Leukemia
Initial criteria
- Approve for 1 year if ONE of the following (A or B) is met:
- A) Patient has Philadelphia chromosome-positive acute lymphoblastic leukemia; OR
- B) Patient has ABL-class translocation.
Approval duration
1 year