Ayvakit (avapritinib) — United Healthcare
Systemic Mastocytosis (advanced, aggressive, associated hematologic neoplasm, mast cell leukemia, indolent)
Initial criteria
- Diagnosis of one of the following: advanced systemic mastocytosis; aggressive systemic mastocytosis; systemic mastocytosis with an associated hematologic neoplasm; mast cell leukemia; indolent systemic mastocytosis
- Platelet count is greater than or equal to 50 x 10^9/L
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Ayvakit therapy
Approval duration
12 months