NCCN Guidelines in Focus: Key Updates for Follicular Lymphoma and Their Impact on Formulary Decisions

This episode, titled 'NCCN Guidelines in Focus: Key Updates for Follicular Lymphoma and Their Impact on Formulary Decisions,' features Ryan Haumschild, PharmD, MS, MBA, CPEL discussing the following critical questions:

1. What would you identify as key updates within the latest NCCN guidelines for FL?
2. How do NCCN guidelines inform your formulary decisions, and what is the process by which a new regimen's guideline inclusion triggers institutional review?

Ryan Haumschild highlighted the most meaningful recent updates to the NCCN guidelines for follicular lymphoma, noting that while chemoimmunotherapy backbones and anti-CD20 agents remain part of the framework, the guidelines are increasingly reflecting the shift toward targeted, non-chemotherapy regimens — most notably the Category 1 recommendation for tafasitamab in combination with rituximab and lenalidomide in the relapsed or refractory post-anti-CD20 setting, as well as growing incorporation of bispecific agents such as epcoritamab as data continues to mature. He also discussed the NCCN's continued emphasis on identifying POD24 patients and recommending biopsy to evaluate for transformation in this high-risk population, underscoring that risk stratification remains a central pillar of the guideline framework. Ryan Haumschild further explained how NCCN category designations directly drive institutional formulary review, noting that Category 2A designations and above typically trigger evaluation for formulary adoption, with the review process focused not just on whether to add a therapy, but on defining which specific patient populations will derive the most value, enabling institutions to build precise, criteria-driven pathways that support faster time to treatment and more consistent, evidence-based prescribing decisions across care settings.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'Streamlining Prior Authorization: Strategies for Securing Timely Access to New RRFL Regimens,' Ryan Haumschild will continue his discussion on follicular lymphoma and highlight the operational strategies and infrastructure investments that can improve prior authorization success rates for newer combination regimens — including the role of comprehensive order sets, complete documentation packages, and proactive appeal preparation in reducing delays and ensuring patients receive timely access to the most appropriate therapy.