Tasigna — Medica
Chronic myeloid leukemia (CML), Philadelphia chromosome positive (Ph+), newly diagnosed chronic phase
Preferred products
- generic nilotinib capsules
Initial criteria
- Patient meets the standard Oncology – Nilotinib Products Prior Authorization Policy criteria AND
- Patient has tried generic nilotinib capsules [documentation required] AND
- Patient cannot continue to use the Preferred medication due to a formulation difference in the inactive ingredient(s) which, per the prescriber, would result in a significant allergy or serious adverse reaction [documentation required]
Approval duration
1 year