Gomekli (mirdametinib) — United Healthcare
Neurofibromatosis type 1 (NF1) with symptomatic plexiform neurofibromas not amenable to complete resection
Initial criteria
- Patient is less than 19 years of age OR Diagnosis of neurofibromatosis type 1 AND Plexiform neurofibromas (PN) that are symptomatic AND Not amenable to complete resection
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Gomekli therapy
Approval duration
12 months