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Votrient (pazopanib)United Healthcare

Gastrointestinal Stromal Tumor (GIST)

Preferred products

  • Gleevec (imatinib)
  • Sutent (sunitinib)
  • Stivarga (regorafenib)
  • Qinlock (ripretinib)

Initial criteria

  • Diagnosis of GIST AND disease is unresectable, progressive, or metastatic AND (used as first-line therapy in SDH-deficient GIST OR used after progression on all of the following: Gleevec (imatinib), Sutent (sunitinib), Stivarga (regorafenib), standard dose Qinlock (ripretinib))

Reauthorization criteria

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

Approval duration

12 months