Rydapt (midostaurin) — United Healthcare
Acute Myeloid Leukemia (AML)
Initial criteria
- Diagnosis of acute myeloid leukemia (AML)
- AND AML is FLT3 mutation-positive
- AND Rydapt will be used in combination with standard induction and consolidation therapy
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Rydapt therapy
Approval duration
12 months