Enasidenib (Idhifa)

SELF ADMINISTRATION

Indications for Prior Authorization:

  • Treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with isocitrate dehydrogenase-2 (IDH2) positive mutation as detected by an FDA-approved test

All of the following must be met as a condition for coverage:

  • Prescribed by an oncologist, AND
  • Patient is 18 years or older, AND
  • Confirmed presence of IDH2 mutations in the blood or bone marrow

Dosing:

  • 100 mg orally once daily

Approval:

  • 1 year

Last review date: September 4, 2018