Qinlock (ripretinib) — Highmark
Advanced Gastrointestinal Stromal Tumor (GIST)
Preferred products
- imatinib
- two other kinase inhibitors
Initial criteria
- age ≥ 18 years
- diagnosis of advanced GIST (ICD-10: C49.A)
- experienced therapeutic failure, intolerance, or contraindication to imatinib AND two other kinase inhibitors
Reauthorization criteria
- prescriber attests that the member is tolerating therapy
- therapeutic response defined as disease improvement OR delayed disease progression
Approval duration
12 months