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Medical Criteria Update for March 22, 2022 March 22, 2022
Medical CriteriaReason for Update
CAR-T Therapy (PDF)Added new to market drug to policy with indication of the treatment of adults with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Updated dosing table/max units with new drug.
Erythropoiesis-Stimulating Agents (ESAs) (PDF)Criteria change: Removal of code Q5105 from dosing table (no review required, this code was never added to the PPA list).

 

 

 

 

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