ivosidenib — United Healthcare

Initial criteria

• Diagnosis of acute myeloid leukemia (AML)
• AML is IDH1 mutation-positive
• ONE of the following: Disease is relapsed or refractory OR (New diagnosis of AML AND ONE of the following: patient ≥ 75 years old OR patient has comorbidities that preclude the use of intensive induction chemotherapy OR patient ≥ 60 years old and not a candidate for or declines intensive induction therapy OR patient ≥ 60 years old and receiving post-induction therapy following response to previous lower intensity therapy)

Reauthorization criteria

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

Approval duration

12 months