How to Help Your Patients Find Gomekli In Stock: A Provider's Guide

Gomekli (mirdametinib), FDA-approved in February 2025 for NF1 with inoperable plexiform neurofibromas, represents a major step forward for NF1 patients — but accessing it requires navigating a multi-step specialty drug access pathway. For NF1 specialists, oncologists, and their teams, having a clear, repeatable workflow for getting Gomekli into patients' hands can dramatically reduce treatment delays. This guide walks through the entire process.

Step 1: Confirm Patient Eligibility Before Prescribing

Before initiating the access process, confirm the patient meets the FDA-approved indication criteria. Gomekli is approved for adults and pediatric patients aged 2 years and older with NF1 who have:

Confirmed NF1 diagnosis (genetic testing confirming NF1 gene mutation, or two or more clinical NF1 diagnostic criteria)

Symptomatic plexiform neurofibromas (causing pain, functional impairment, or disfigurement)

PNs not amenable to complete resection

Also complete the required pre-treatment workup before writing the prescription:

Baseline echocardiogram (for left ventricular function assessment)

Comprehensive ophthalmic assessment (before initiating Gomekli)

Pregnancy test for females of reproductive potential

Baseline body surface area (BSA) calculation for dosing

Step 2: Enroll the Patient in SpringWorks CareConnections

Enroll patients in SpringWorks CareConnections at the same time you write the prescription — do not wait. The enrollment form is available at springworkstxcares.com. Once enrolled, a dedicated Nurse Advocate will contact the patient and serve as their single point of contact throughout treatment.

CareConnections will immediately run a benefits investigation to determine the patient's coverage status and expected out-of-pocket costs. They will also identify the appropriate specialty pharmacy based on the patient's insurance plan.

Step 3: Submit Prior Authorization Proactively

Submit PA documentation as early as possible. Your PA submission should include the diagnosis of NF1, description and imaging documentation of the plexiform neurofibromas, rationale for inoperability, symptom burden documentation, patient BSA for dosing verification, and the planned treatment regimen.

CareConnections' Field Access Managers can provide payor-specific PA templates and help troubleshoot denials. If the initial PA is denied, be prepared to submit a peer-to-peer review request promptly. Document the clinical urgency clearly — NF1-PN is a progressive condition and treatment delays can result in tumor growth and increasing morbidity.

Step 4: Arrange the Specialty Pharmacy

Gomekli is available through a limited specialty pharmacy and distributor network. Your practice should have a list of authorized specialty pharmacies that carry Gomekli. If you're unsure which ones are in-network for your patient's insurance plan, CareConnections can identify the appropriate pharmacy.

You can also use medfinder for providers, which calls specialty pharmacies near the patient to check who can fill the prescription right now. Results are texted to the patient, eliminating time-consuming back-and-forth phone calls for your office staff.

Step 5: Bridge Supply for Patients Experiencing Delays

For patients who cannot wait for insurance approval, CareConnections offers a bridge supply program. Eligible patients experiencing delays in insurance coverage can receive Gomekli at no cost temporarily while coverage is being processed. There are also separate provisions for eligible patients who experience a lapse in insurance coverage after starting treatment.

Step 6: Set Up Monitoring Appointments

Before the patient starts Gomekli, schedule:

Echocardiogram at 3 months after treatment start and every 3 months for the first year

Ophthalmic assessments at regular intervals throughout treatment

Skin assessment follow-up (rash is the most common side effect, occurring in >25% of patients)

Volumetric MRI assessments per institution protocol to evaluate tumor response

Dosing Reference: Gomekli Dosing by Body Surface Area

The recommended dose of Gomekli is 2 mg/m² orally twice daily for the first 21 days of each 28-day treatment cycle, with or without food. The maximum dose is 4 mg twice daily. Doses should be based on current BSA and rounded to the nearest available capsule or tablet strength (1 mg and 2 mg capsules; 1 mg dispersible tablets). Continue treatment until disease progression or unacceptable toxicity.

For more information on the current availability status of Gomekli and what to expect with insurance, see our article on what providers need to know about Gomekli access in 2026.