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The Policy VaultThe Policy Vault

Afinitor DisperzCareFirst (Caremark)

Hormone receptor-positive, HER2-negative recurrent unresectable, advanced, or metastatic breast cancer (in combination with exemestane, fulvestrant, or tamoxifen)

Initial criteria

  • Patient has hormone receptor (HR)-positive, HER2-negative recurrent unresectable, advanced, or metastatic breast cancer
  • Requested medication will be used in combination with exemestane, fulvestrant, or tamoxifen

Reauthorization criteria

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

Approval duration

12 months