lapatinib — CareFirst (Caremark)

Initial criteria

• Member has no response to preoperative systemic therapy or has recurrent, advanced, or metastatic HER2-positive breast cancer
• Requested medication is used in combination with an aromatase inhibitor (e.g., letrozole, anastrozole, or exemestane) either with or without trastuzumab for hormone receptor-positive disease OR used in combination with capecitabine or trastuzumab

Reauthorization criteria

• No evidence of unacceptable toxicity or disease progression while on current regimen

Approval duration

12 months