Danziten (nilotinib) — United Healthcare
Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia (Ph+ B-ALL)
Initial criteria
- For patients <19 years of age: patient is less than 19 years of age
- For Chronic Myeloid Leukemia: diagnosis of chronic myeloid leukemia
- For Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia (Ph+ B-ALL): diagnosis of Ph+ B-ALL
- For Soft Tissue Sarcoma (pigmented villonodular synovitis/tenosynovial giant cell tumor): diagnosis of pigmented villonodular synovitis/tenosynovial giant cell tumor
- For NCCN Recommended Regimens: drug is recognized by the NCCN Drugs and Biologics Compendium for the cancer indication with Category of Evidence and Consensus of 1, 2A, or 2B
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Danziten therapy
Approval duration
12 months