Yonsa — CareFirst (Caremark)

Initial criteria

• Member has metastatic castration-resistant prostate cancer.
• Member has had a bilateral orchiectomy OR will be using the requested medication in combination with a luteinizing hormone-releasing hormone (LHRH) agonist (e.g., goserelin, leuprolide) OR an antagonist (e.g., degarelix, relugolix).
• Requested medication will not be used in combination with a second-generation oral anti-androgen (e.g., apalutamide [Erleada]) or an oral androgen metabolism inhibitor (e.g., abiraterone acetate [Zytiga]).

Reauthorization criteria

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

Approval duration

12 months