osimertinib — CareFirst (Caremark)
Consolidation therapy for unresectable stage II-III NSCLC after definitive concurrent chemoradiation
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)