Augtyro — CareFirst (Caremark)
Recurrent, advanced, or metastatic ROS1-positive non-small cell lung cancer
Initial criteria
- Diagnosis of recurrent, advanced, or metastatic non-small cell lung cancer (NSCLC)
- Tumor is ROS1-positive or NTRK gene fusion-positive as demonstrated by laboratory testing
- Medication will be used as a single agent
Reauthorization criteria
- No evidence of unacceptable toxicity while on the current regimen
Approval duration
12 months