Erleada — CareFirst (Caremark)

Initial criteria

• Member has had a bilateral orchiectomy OR will be using the requested medication in combination with a luteinizing hormone-release hormone (LHRH) agonist (e.g., goserelin, leuprolide) or antagonist (e.g., degarelix, relugolix)
• Requested indication is non-metastatic castration-resistant prostate cancer OR metastatic castration-sensitive prostate cancer
• Requested medication is not used in combination with a second-generation oral anti-androgen (e.g., enzalutamide [Xtandi]) or an oral androgen metabolism inhibitor (e.g., abiraterone acetate [Zytiga])

Reauthorization criteria

• No evidence of unacceptable toxicity or disease progression while on the current regimen
• Member continues to meet initial indication requirements

Approval duration

12 months