abemaciclib — CareFirst (Caremark)

Initial criteria

• Member has hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, recurrent or metastatic breast cancer
• Requested medication is used in one of the following regimens: as monotherapy for a member who has experienced disease progression following endocrine therapy and prior chemotherapy in the metastatic setting; OR in combination with fulvestrant; OR in combination with an aromatase inhibitor (e.g., letrozole, anastrozole, exemestane)

Reauthorization criteria

• No evidence of unacceptable toxicity or disease progression while on the current regimen

Approval duration

12 months