ceritinib — CareFirst (Caremark)
Non-small cell lung cancer (NSCLC), recurrent, advanced, or metastatic ALK-positive NSCLC (including brain metastases from NSCLC)
Initial criteria
- Member has recurrent, advanced, or metastatic ALK-positive NSCLC (including brain metastases from NSCLC)
- Used as a single agent
Reauthorization criteria
- No evidence of unacceptable toxicity while on the current regimen
Approval duration
12 months