Skip to content
The Policy VaultThe Policy Vault

Zytiga/abiraterone 500 mgBlue Cross Blue Shield of Oklahoma

stage four advanced metastatic cancer or associated condition

Preferred products

  • generic abiraterone 250 mg tablets

Initial criteria

  • ONE of the following:
  • A. BOTH of the following:
  • 1. Diagnosis of stage four advanced metastatic cancer and requested agent used to treat cancer or associated condition AND
  • 2. Use consistent with best practices supported by peer-reviewed literature and FDA approval OR
  • B. Currently treated and stable on requested agent OR
  • C. Tried and had inadequate response to generic abiraterone 250 mg tablets OR
  • D. Generic abiraterone 250 mg tablets discontinued due to lack of efficacy, diminished effect, or adverse event OR
  • E. Intolerance or hypersensitivity to generic abiraterone 250 mg tablets not expected with requested agent OR
  • F. FDA labeled contraindication to generic abiraterone 250 mg tablets not expected with requested agent OR
  • G. Generic abiraterone 250 mg tablets expected to be ineffective, cause adherence barrier, worsen comorbidity, decrease function, or cause harm OR
  • H. Generic abiraterone 250 mg tablets not in best interest of patient OR
  • I. Tried another drug in same class or mechanism as generic abiraterone 250 mg tablets and discontinued OR
  • J. Support for use over generic abiraterone 250 mg tablets