Pharmacy Prior Authorization Criteria

Xpovio (selinexor)

For diagnosis of Multiple Myeloma
1) Indicated in combination with bortezomib and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy.
2) Indicated in combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody.

Prior Authorization (Initial Authorization)

Length of Approval: 12 Month(s)

Prior Authorization (Reauthorization)

Length of Approval: 12 Month(s)

2026-06-10, 2026-02-03, 2025-05-14, 2025-04-14, 2024-05-30, 2023-07-18, 2023-06-07, 2022-06-16, 2021-06-01, 2021-02-03, 2020-07-28, 2019-08-21

Xpovio Prescribing Information. Karyopharm Therapeutics Inc. Newton, MA. April 2026.

2026-06-10: Remove criteria for Diffuse large B-cell lymphoma due to indication withdrawal 2026 Annual Review: no additional criteria updates
2026-02-03: Added Xpovio 80mg once weekly pack to guideline
2025-05-14: 2025 Annual Review. Background updates only.
2025-04-14: Added new Xpovio 40mg once weekly to guideline
2024-05-30: 2024 annual review. GPI clean up. No changes to clinical intent.
2023-07-18: Removed Oncology specialist requirement
2023-06-07: Annual review: Program update to consolidate Multiple Myeloma and Diffuse Large B Cell Lymphoma criteria into one criteria set that asks for diagnosis and prescriber requirement only. All other criteria removed.
2022-06-16: Annual review - updated references.
2021-06-01: Added GPIs for new Xpovio tablet packs.
2021-02-03: Added new indication for multiple myeloma. Updated background and references.
2020-07-28: New indication for DLBCL. Added new GPIs. Removed drug name from reauth criteria for consistency. Updated background and references.
2019-08-21: New PA for Xpovio.