Tukysa (tucatinib) — CareFirst (Caremark)

Initial criteria

• Medication is used in combination with trastuzumab and capecitabine
• Member has HER2-positive breast cancer
• One of the following: member has no response to preoperative systemic therapy, recurrent unresectable, advanced unresectable, or metastatic disease including limited or extensive brain metastases; OR member has small asymptomatic brain metastases as initial therapy

Reauthorization criteria

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

Approval duration

12 months