Oncology - Inrebic Prior Authorization Policy
Defines prior authorization criteria for coverage of Inrebic (fedratinib capsules) for FDA-approved indication (myelofibrosis) and select other uses with supportive evidence (accelerated/blast phase myeloproliferative neoplasm; myeloid or lymphoid neoplasms with eosinophilia and JAK2 rearrangement). Approvals are for 1 year when criteria are met.
Myelofibrosis criterion changed from 'intermediate-2 or high-risk disease' to 'higher-risk disease.'
Accelerated or Blast Phase Myeloproliferative Neoplasm condition of approval and criteria were added.
For myeloid or lymphoid neoplasms, requirement that the patient has tried Jakafi (ruxolitinib) was added.
Annual revisions on 10/11/2023 and 06/26/2024 noted 'No criteria changes.'
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