Bruton Tyrosine Kinase Inhibitors
Pharmacy coverage and medical necessity criteria for multiple Bruton's tyrosine kinase (BTK) inhibitor drugs for adults (and select pediatric indication for cGVHD) managed under the pharmacy benefit for Premera Bluecross members.
Added coverage criteria for Wayrilz (rilzabrutinib) for treatment of adult patients with persistent or chronic immune thrombocytopenia (ITP) with insufficient response to a previous treatment.
Added information and trial results for Rhapsido (remibrutinib) for chronic spontaneous urticaria (CSU).
Updated Brukinsa (zanubrutinib) coverage criteria to include treatment of certain individuals with follicular lymphoma.
Updated Imbruvica (ibrutinib) coverage criteria to limit use to adults and adjusted age requirement for chronic GVHD indication.
Added new indication to Calquence (acalabrutinib) for previously untreated mantle cell lymphoma (MCL).
Title changed to Bruton Tyrosine Kinase Inhibitors.
Added coverage criteria for Rhapsido (remibrutinib) for treatment of chronic spontaneous urticaria (CSU) in adults symptomatic despite H1 antihistamine treatment.
Added coverage criteria for Wayrilz (rilzabrutinib) for adult patients with persistent or chronic immune thrombocytopenia (ITP) after insufficient response to prior treatment.
Updated Jaypirca (pirtobrutinib) coverage criteria for relapsed/refractory CLL/SLL removing requirement of two prior lines of therapy including a BCL-2 inhibitor.
Updated age requirement for Imbruvica (ibrutinib) chronic graft versus host disease coverage from ≥18 years to ≥1 year.
Added new indication to Calquence (acalabrutinib) for treatment of adults with previously untreated mantle cell lymphoma.
Removed Imbruvica's indications of Mantle Cell Lymphoma and Marginal Zone Lymphoma to match FDA label changes.
Added coverage for Jaypirca (pirtobrutinib) for the treatment of relapsed or refractory mantle cell lymphoma (MCL).
Added coverage for Brukinsa (zanubrutinib) for Waldenström's macroglobulinemia and marginal zone lymphoma; later added CLL/SLL and follicular lymphoma indications.
Medications listed are subject to the product's FDA dosage and administration prescribing information.
Non-formulary exception authorizations for all drugs listed may be approved up to 12 months.
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