UnitedHealthcare
Vonjo (pacritinib)
Drugs for Cancer : Drugs for Cancer
  • Myelofibrosis:
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)

  • Prior Authorization: Myelofibrosis:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 6 Month(s)
    Reauthorization Required: Yes

  • Quantity Limit: limit maximum 4 EA PER 1 day(s)
  • Orally administered anticancer medication.