Teclistamab-cqyv (Tecvayli) (CPB 1018, reviewed 2026-06-08)
Summary
Aetna's Clinical Policy Bulletin 1018 covers teclistamab-cqyv (Tecvayli) for commercial medical plans and requires precertification from Aetna for participating providers and members in applicable plan designs. Aetna considers it medically necessary for relapsed or refractory multiple myeloma when specific criteria are met: use with daratumumab (Darzalex) or daratumumab and hyaluronidase-fihj (Darzalex Faspro) in a member who is bortezomib-refractory or lenalidomide-refractory; use as a single agent after at least 4 prior therapies that include a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 monoclonal antibody; or use with talquetamab-tgvs (Talvey) after at least 3 prior therapies. It also covers POEMS syndrome, monoclonal immunoglobulin deposition disease (MIDD) and plasma cell-related monoclonal gammopathy of renal significance (MGRS) under the stated criteria. Aetna considers all other indications experimental, investigational or unproven, and considers continuation of therapy medically necessary when there is no evidence of unacceptable toxicity or disease progression.
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