Thalomid (thalidomide) — United Healthcare

Initial criteria

• Diagnosis of Castleman Disease (CD)
• AND
• One of the following:
• Not used as first line therapy
• OR
• All of the following:
• Therapy is for active idiopathic multicentric CD with no evidence of organ failure
• Used in combination with cyclophosphamide and prednisone
• Patient is human immunodeficiency virus (HIV)-negative
• Patient is human herpesvirus-8 (HHV8)-negative

Reauthorization criteria

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

Approval duration

12 months