Sprycel (dasatinib tablets - Bristol-Myers Squibb; generic) — Cigna
Chronic Myeloid Leukemia
Initial criteria
- Approve for 1 year if ONE of the following (A or B) is met:
- A) Patient has Philadelphia chromosome-positive chronic myeloid leukemia; OR
- B) Patient has BCR::ABL1-positive chronic myeloid leukemia.
Approval duration
1 year