Multiple Myeloma:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: 1 of Clinical Pharmacology;FDA Approved Indications;NCCN Guidelines;Wolters Kluwer Lexi-Drugs
ECOG Score Requirement in Policy: N/A
ECOG status <=2: No
Diagnosis Types: 1 of in combination with lenalidomide plus dexamethasone in relapsed or refractory multiple myeloma after one to three line of therapy;in combination with pomalidomide and dexamethasone after at least two prior therapies including lenalidomide and a proteasome inhibitor;Other recommended regimens for previously treated multiple myeloma: elotuzumab, bortezomib, dexamethasone;Progressive disease;Refractory disease;Relapsed disease
Concomitant Therapy Requirement: 1 of in combination with bortezomib and dexamethasone;in combination with lenalidomide and dexamethasone;in combination with pomalidomide and dexamethasone