Fruzaqla — CareFirst (Caremark)

Initial criteria

• Member is an adult (age ≥ 18 years)
• Diagnosis of advanced or metastatic colorectal cancer, including appendiceal adenocarcinoma and anal adenocarcinoma
• Used as a single agent
• Member has progressed on previous treatment with all of the following regimens unless contraindicated or intolerant: fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy (with or without bevacizumab)
• If RAS mutation status is negative (wild-type) and medically appropriate, member has progressed on an anti-epidermal growth factor receptor (EGFR) therapy

Reauthorization criteria

• No evidence of unacceptable toxicity with Fruzaqla treatment
• No evidence of disease progression while on the current regimen

Approval duration

12 months