Krazati (adagrasib) — CareFirst (Caremark)
recurrent, advanced, or metastatic KRAS G12C mutation positive non-small cell lung cancer (NSCLC)
Initial criteria
- Diagnosis of recurrent, advanced, or metastatic KRAS G12C mutation positive NSCLC
- KRAZATI will be used as a single agent
- Either of the following criteria are met: (a) member has received at least one prior systemic therapy and has not experienced disease progression on KRAS G12C-targeted therapy OR (b) member has brain metastases
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on the current regimen
Approval duration
12 months