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Zydelig (idelalisib tablets - Gilead)Cigna

Small Lymphocytic Lymphoma

Initial criteria

  • Patient is age ≥ 18 years; AND
  • Patient has tried at least one Bruton tyrosine kinase inhibitor (e.g., Imbruvica [ibrutinib], Brukinsa [zanubrutinib], Calquence [acalabrutinib], or Jaypirca [pirtobrutinib]); AND
  • Patient has tried at least one B-cell lymphoma 2 inhibitor (e.g., Venclexta [venetoclax]).

Approval duration

1 year