UnitedHealthcare
Rituxan Hycela (rituximab-hyaluronidase,human)
Drugs for Cancer : Drugs for Cancer
  • Step Therapy Applies
  • Prior Authorization: Chronic Lymphocytic Leukemia:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)

  • Chronic Lymphocytic Leukemia:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Drug Policy Based On: NCCN Guidelines
    Diagnosis Types: Medically accepted uses supported by NCCN Category 1, 2A or 2B level of evidence