Ibtrozi — CareFirst (Caremark)
ROS1-positive non-small cell lung cancer (NSCLC)
Initial criteria
- Diagnosis of recurrent, advanced, or metastatic ROS1-positive non-small cell lung cancer (NSCLC)
- Used as a single agent
Reauthorization criteria
- Diagnosis of ROS1-positive non-small cell lung cancer (NSCLC)
- No evidence of unacceptable toxicity while on the current regimen
Approval duration
12 months