Mektovi (binimetinib) — United Healthcare

Initial criteria

• Diagnosis of one of the following: Multisystem Langerhans Cell Histiocytosis OR Single-system lung Langerhans Cell Histiocytosis OR Langerhans Cell Histiocytosis with CNS lesions
• EITHER (disease positive for mitogen-activated protein (MAP) kinase pathway mutation) OR (no other detectable/actionable mutation) OR (testing not available)

Reauthorization criteria

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

Approval duration

12 months