Jaypirca (pirtobrutinib) — United Healthcare
Chronic lymphocytic leukemia (CLL)
Preferred products
- Imbruvica (ibrutinib)
- Calquence (acalabrutinib)
- Brukinsa (zanubrutinib)
- Venclexta (venetoclax)
Initial criteria
- Diagnosis of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)
- Patient has been previously treated with both of the following: Bruton Tyrosine Kinase (BTK) inhibitor therapy [e.g., Imbruvica (ibrutinib), Calquence (acalabrutinib), Brukinsa (zanubrutinib)] AND B-cell lymphoma 2 (BCL-2) inhibitor therapy [e.g., Venclexta (venetoclax)]
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Jaypirca therapy
Approval duration
12 months