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OjemdaUnited Healthcare

pediatric low-grade glioma

Initial criteria

  • Diagnosis of pediatric low-grade glioma
  • Disease is relapsed or refractory
  • Presence of one of the following genetic mutations: (a) BRAF fusion or rearrangement OR (b) BRAF V600 mutation

Reauthorization criteria

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

Approval duration

12 months