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Jakafi (ruxolitinib) — Highmark

Acute graft-versus-host disease

Initial criteria

  • age ≥ 12 years
  • diagnosis of steroid-refractory acute graft-versus-host disease
  • therapeutic failure, contraindication, or intolerance to one systemic corticosteroid

Reauthorization criteria

  • prescriber attests member is tolerating therapy and has experienced a therapeutic response defined as disease improvement OR delayed disease progression