Zydelig (idelalisib) — United Healthcare
Small Lymphocytic Lymphoma (SLL)
Initial criteria
- Diagnosis of Chronic Lymphocytic Leukemia (CLL) / small lymphocytic lymphoma (SLL)
- AND
- One of the following: Disease has relapsed OR Disease is refractory
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Zydelig therapy
Approval duration
12 months