Braftovi (encorafenib) — CareFirst (Caremark)
BRAF V600E mutation-positive recurrent, advanced, or metastatic non-small cell lung cancer (NSCLC)
Initial criteria
- Diagnosis of recurrent, advanced, or metastatic NSCLC with documented BRAF V600E mutation confirmed by FDA-approved or validated test
- Used in combination with binimetinib (Mektovi)
- Member has not experienced disease progression on prior BRAF-targeted therapy
Reauthorization criteria
- No evidence of disease progression or unacceptable toxicity while on current regimen
Approval duration
12 months