Hernexeos — CareFirst (Caremark)

Initial criteria

• member is an adult (age ≥ 18 years)
• diagnosis of recurrent, advanced, unresectable, or metastatic non-small cell lung cancer (NSCLC)
• documentation of HER2 (ERBB2) mutation by FDA-approved test
• Hernexeos will be used as a single agent
• member has received prior systemic therapy

Reauthorization criteria

• member has an indication listed in the coverage criteria section
• no evidence of unacceptable toxicity while on the current regimen
• no evidence of disease progression while on the current regimen

Approval duration

12 months