Koselugo (selumetinib) — United Healthcare
NF-1 mutated glioma
Initial criteria
- One of the following:
- a. Circumscribed glioma with presence of BRAF fusion or BRAF V600E activating mutations
- b. NF-1 mutated glioma
- Disease is recurrent or progressive
- Used as monotherapy
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Koselugo therapy
Approval duration
12 months