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The Policy VaultThe Policy Vault

Inqovi (decitabine and cedazuridine)United Healthcare

Myelodysplastic syndrome (MDS) including previously treated and untreated, de novo and secondary MDS with French-American-British subtypes (refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, and chronic myelomonocytic leukemia [CMML])

Initial criteria

  • Diagnosis of myelodysplastic syndrome [e.g., previously treated and untreated, de novo and secondary MDS with the following French-American-British subtypes (refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, and chronic myelomonocytic leukemia (CMML))]
  • AND Patient is intermediate-1, intermediate-2, or high-risk per the International Prognostic Scoring System (IPSS)

Reauthorization criteria

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

Approval duration

12 months