Thalomid (thalidomide capsules) — Cigna

Initial criteria

• Patient age < 18 years AND
• Patient has recurrent or progressive disease AND
• Medication is being used as part of the MEMMAT regimen (Thalomid, celecoxib, fenofibrate, oral etoposide, cyclophosphamide, bevacizumab, and intraventricular etoposide)

Approval duration

1 year