Komzifti
Defines accepted indications, contraindications, exclusion criteria, required supporting evidence, and coding for ziftomenib (Komzifti) use in adults with relapsed/refractory acute myeloid leukemia (AML) with NPM1 mutation. Specifies treatment duration guidance, monitoring warnings, and utilization management responsibilities.
New policy created (Policy history notes December 2025: New policy).
Coverage Summary
Coverage stance: Komzifti (ziftomenib) is covered with criteria for adult patients with relapsed or refractory acute myeloid leukemia (AML) harboring a susceptible NPM1 mutation. Evolent manages all medication requests and prior authorization; continuation requests may be exempt if continuity criteria are met.