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Xermelo (telotristat ethyl)Highmark

carcinoid syndrome diarrhea

Initial criteria

  • age ≥ 18 years
  • Diagnosis of carcinoid syndrome (ICD-10: E34.0) diarrhea
  • Use in combination with a somatostatin analog
  • Inadequate control on somatostatin analog monotherapy

Reauthorization criteria

  • Reduction in average number of daily bowel movements
  • Continued use in combination with a somatostatin analog

Approval duration

Initial: up to 3 months (12 months for Delaware Commercial fully-insured and ACA members); Reauthorization: up to 12 months