Imbruvica (ibrutinib) — Medica

Initial criteria

• Patient is age ≥ 18 years
• Patient meets ONE of the following:
• • Continuing therapy with Imbruvica AND has tried at least one systemic regimen (e.g., bendamustine, rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone, cytarabine, carboplatin, cisplatin, oxaliplatin, lenalidomide)
• • Continuing therapy with Imbruvica AND according to the prescriber, patient is not a candidate for a chemotherapy regimen
• • Imbruvica is used in combination with rituximab prior to induction therapy (e.g., rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone)
• • Imbruvica is used as induction or maintenance therapy in combination with chemotherapy

Reauthorization criteria

• Patient continues to meet initial criteria

Approval duration

1 year