Rebyota and Ryoncil will have additional requirements for most commercial members starting March 31
Ryoncil • The member must have tried and failed, or have a contraindication or intolerance to, Jakafi® (ruxolitinib) when age appropriate per FDA labeling. • The provider must attest to providing clinical outcome information within the appropriate provider portal as requested by Blue Cross or BCN
You can see the full list of requirements in the updated medical policies, which will be available no later than March 31, 2025
WOW- so 12-18 year olds must be SR steroid refractory- then Rux Refractory- before using Ryoncil. There is a rather large hand of something involved here.
How does that work with Grade 3/4 when Rux has not demonstrated efficacy in the most severe cases- outcome is death.
I would envisage insurers need to see Real World Evidence of patients failing Rux and then being cured by Ryoncil. Then they will be asking the question, why are we reimbursing for Rux?
Anyhoo- MARCH 31st is the only potential launch date we have.
Company better update Monday or we are back at $2.50.
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