Anthem Blue Cross (HMO, PPO, EPO)
Imbruvica (ibrutinib)
Drugs for Cancer : Drugs for Cancer
  • Quantity Limit: 2 boxes per 30 day(s).
  • Step Therapy: ST_APPLIES
  • Duchenne Muscular Dystrophy (DMD):
    Duration: 6 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: Unspecified
    Specialty Pharmacy is Required: Not Defined

  • Quantity Limit: 2 tablets per 1 day(s).
  • Paroxysmal Nocturnal Hemoglobinuria:
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): Hematologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)

  • ST Applies