zongertinib — CareFirst (Caremark)
unresectable or metastatic non-squamous non-small cell lung cancer (NSCLC) with HER2 (ERBB2) mutation
Initial criteria
- member is an adult (age ≥ 18 years)
- diagnosis of recurrent, advanced, unresectable, or metastatic non-small cell lung cancer (NSCLC)
- documentation of HER2 (ERBB2) mutation by FDA-approved test
- Hernexeos will be used as a single agent
- member has received prior systemic therapy
Reauthorization criteria
- member has an indication listed in the coverage criteria section
- no evidence of unacceptable toxicity while on the current regimen
- no evidence of disease progression while on the current regimen
Approval duration
12 months