Ayvakit (avapritinib) — Highmark

Initial criteria

• age ≥ 18 years
• diagnosis of one of the following: aggressive systemic mastocytosis (ICD-10: C96.21) OR systemic mastocytosis with an associated hematological neoplasm (ICD-10: D47.02) OR mast cell leukemia (ICD-10: C94.3) OR indolent systemic mastocytosis (ICD-10: D47.02)
• platelet count ≥ 50 x 10^9/L

Reauthorization criteria

• prescriber attests that the member is tolerating therapy
• therapeutic response defined as disease improvement OR delayed disease progression

Approval duration

12 months