Lytgobi (futibatinib) — Highmark

Initial criteria

• age ≥ 18 years
• diagnosis of unresectable, locally advanced or metastatic intrahepatic cholangiocarcinoma (ICD-10: C22.1)
• disease harbors FGFR2 gene fusions or other rearrangements
• experienced therapeutic failure or intolerance to at least one prior therapy

Reauthorization criteria

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

Approval duration

12 months