Anthem Blue Cross (HMO, PPO, EPO)
Xpovio (100 MG Once Weekly) (selinexor)
Drugs for Cancer : Drugs for Cancer
  • Diffuse Large B-Cell Lymphoma:
    Duration: 1 year(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: No
    Duration of Reauthorization: N/A

    Multiple Myeloma:
    Duration: 1 year(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Oncologist
    Reauthorization Required: No
    Duration of Reauthorization: N/A
    Drug Policy Based On: Payer Specific
    ECOG Score Requirement in Policy: N/A
    ECOG status <=2: No
    Diagnosis Types: 1 of in combination with dexamethasone for the treatment of relapsed or refractory multiple myeloma who have received at least four prior therapies and refractory to at least two proteasome inhibitors at least two immunomodulatory agents,and an anti-CD38 monoclonal antibody;patients who have received at least one prior therapy
    Concomitant Therapy Requirement: 1 of in combination with bortezomib and dexamethasone;in combination with dexamethasone
    Policy Allows for Use as Combination Therapy: Yes
    Policy Allows for Use Monotherapy Therapy: No

  • Prior Authorization: Documented Diagnosis: Yes
    Duration: 1 year(s)