Copiktra (duvelisib) — United Healthcare

Initial criteria

• Diagnosis of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)
• Disease is relapsed or refractory
• History of failure, contraindication, or intolerance to at least two prior therapies for CLL/SLL (examples include chlorambucil, obinutuzumab, ofatumumab, bendamustine, ibrutinib, acalabrutinib, venetoclax)

Reauthorization criteria

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

Approval duration

12 months