tovorafenib — United Healthcare

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