Tibsovo (ivosidenib) — Highmark

Initial criteria

• age ≥ 18 years
• diagnosis of locally advanced or metastatic cholangiocarcinoma (ICD-10 C22, C22.1, C24.0, C24.1, C24.8, C24.9, C78.7)
• member has received previous treatment for cholangiocarcinoma
• disease is IDH1 mutation-positive as detected by an FDA-approved companion diagnostic test

Reauthorization criteria

• prescriber attests that the member is tolerating therapy and has experienced a therapeutic response defined as either disease improvement or delayed disease progression

Approval duration

12 months