Rydapt (midostaurin) — United Healthcare
Myeloid/lymphoid or mixed lineage neoplasms with eosinophilia and FGFR1 or FLT3 rearrangement
Initial criteria
- Diagnosis of lymphoid, myeloid, or mixed lineage neoplasms with eosinophilia
- AND Presence of an FGFR1 rearrangement OR Presence of an FLT3 rearrangement
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Rydapt therapy
Approval duration
12 months