Nexavar (sorafenib tosylate) — United Healthcare
acute myeloid leukemia (AML)
Preferred products
- Vidaza (azacitidine)
- Dacogen (decitabine)
Initial criteria
- Diagnosis of acute myeloid leukemia (AML)
- AND Patient has FLT3‑ITD mutation‑positive disease
- AND Patient has relapsed or refractory disease
- AND Used in combination with Vidaza (azacitidine) OR Dacogen (decitabine)
- AND Patient is unable to tolerate more aggressive treatment regimens
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Nexavar therapy
Approval duration
12 months