Turalio (pexidartinib) — Highmark
symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery or not a candidate for surgery
Initial criteria
- age ≥ 18 years
- diagnosis of symptomatic tenosynovial giant cell tumor (TGCT) (ICD-10: M12, M65) associated with severe morbidity or functional limitations
- member is not amenable to improvement with surgery OR is not a candidate for surgery
Reauthorization criteria
- prescriber attests member is tolerating therapy
- prescriber attests member has experienced disease improvement OR delayed disease progression
Approval duration
12 months