Rubraca (rucaparib) — CareFirst (Caremark)
Metastatic castration-resistant prostate cancer (mCRPC)
Initial criteria
- Tumor has a deleterious BRCA mutation (germline, somatic, or both)
- Member has been treated with androgen receptor-directed therapy
- Member has been treated with a taxane-based chemotherapy or is not fit for chemotherapy
- Member is receiving therapy concurrently with a luteinizing hormone-releasing hormone (LHRH) agonist (e.g., goserelin, leuprolide) or antagonist (e.g., degarelix, relugolix) or has had a bilateral orchiectomy
- Medication will be used as a single agent (concurrent LHRH agonist/antagonist is allowed)
Reauthorization criteria
- No evidence of unacceptable toxicity or disease progression while on current regimen
Approval duration
12 months