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osimertinibCareFirst (Caremark)

Adjuvant treatment of NSCLC after complete tumor resection or node positive NSCLC

Initial criteria

  • Member has EGFR-sensitizing mutation-positive disease as detected by an FDA-approved test
  • Requested for use as a single agent or in combination with pemetrexed and either cisplatin or carboplatin for recurrent, advanced, or metastatic NSCLC
  • Requested for use as a single agent for adjuvant treatment of NSCLC with EGFR mutation-positive disease and complete tumor resection or node positive disease
  • Requested for use as a single agent for consolidation therapy of EGFR mutation-positive unresectable stage II-III NSCLC when there is no disease progression after definitive concurrent chemoradiation

Reauthorization criteria

  • For adjuvant treatment of NSCLC: no evidence of unacceptable toxicity or disease recurrence while on current regimen
  • For recurrent, advanced, or metastatic NSCLC: no evidence of unacceptable toxicity while on current regimen

Approval duration

12 months (up to 3 years for adjuvant treatment)