Skip to content
The Policy VaultThe Policy Vault

Alecensa (alectinib)United Healthcare

Soft Tissue Sarcoma / Uterine Neoplasms - Inflammatory Myofibroblastic Tumor (IMT)

Initial criteria

  • Diagnosis of inflammatory myofibroblastic tumor (IMT)
  • Presence of ALK translocation

Reauthorization criteria

  • Patient does not show evidence of progressive disease while on Alecensa therapy

Approval duration

12 months