| Anthem Blue Cross (HMO, PPO, EPO) |
| romidepsin (romidepsin) |
| Drugs for Cancer : Drugs for Cancer |
- Available only through Specialty Pharmacy;
- Cutaneous T-Cell Lymphomas:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
- Prior Authorization: Cutaneous T-Cell Lymphomas:
Documented Diagnosis: Yes
Duration: 1 year(s)
|