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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