Recorlev (levoketoconazole) — Highmark

Initial criteria

• age ≥ 18 years
• Diagnosis of endogenous Cushing’s syndrome (ICD-10: E24.0, E24.3, E24.8, E24.9)
• Prescribed by or in consultation with an endocrinologist
• Member is not a candidate for surgery OR has experienced therapeutic failure to surgery (has not been curative)
• Member has experienced therapeutic failure, contraindication, or intolerance to ketoconazole tablets

Reauthorization criteria

• Member has experienced a reduction in the 24-hour mean urinary free cortisol (mUFC) levels from baseline
• Prescriber attests to improvement in signs and symptoms of Cushing’s syndrome from baseline

Approval duration

12 months