Rezurock (belumosudil) — Highmark

Initial criteria

• age ≥ 12 years
• diagnosis of chronic graft-versus-host disease (cGVHD)
• therapeutic failure or intolerance to two (2) lines of systemic therapy

Reauthorization criteria

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

Approval duration

12 months