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Besremi (ropeginterferon alfa-2b-njft) — Point32Health

other cancer diagnoses with medically acceptable indication recognized by NCCN Drugs and Biologics Compendium (Category 1 or 2A) or other standard reference compendia/peer-reviewed literature per Massachusetts Sullivan Law

Initial criteria

  • Documented diagnosis of polycythemia vera AND documented inadequate response or intolerance to hydroxyurea
  • OR coverage for other cancer diagnoses when effective treatment with such drug is recognized as a Medically Acceptable Indication according to the NCCN Drugs and Biologics Compendium (Category 1 or 2A) OR recognized in one of the Standard Reference Compendia OR supported by clinical research in Peer-Reviewed Medical Literature per Massachusetts Sullivan Law (M.G.L. c.175, s.47K)