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EntyvioMedical Mutual

Acute Graft Versus Host Disease (aGVHD)

Initial criteria

  • Patient age ≥ 18 years
  • Patient has received an allogeneic hematopoietic stem cell transplant
  • Used for steroid-refractory acute GVHD
  • Used in combination with systemic corticosteroids as additional therapy following no response to first-line therapies
  • Site of care medical necessity is met

Reauthorization criteria

  • Approve for an additional 6 months of therapy if the patient has responded (e.g., clinician assessments such as NIH Skin Score, Upper GI Response Score, NIH Lung Symptom Score, or patient-reported symptoms such as Lee Symptom Scale), as determined by the prescribing physician

Approval duration

14 weeks initial, 6 months reauth