Alecensa (alectinib) — United Healthcare
Histiocytic Neoplasms - Erdheim-Chester Disease
Initial criteria
- Diagnosis of symptomatic Erdheim-Chester Disease
- Used as targeted therapy ALK-fusion
- Disease is one of the following: relapsed OR refractory
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Alecensa therapy
Approval duration
12 months