Erivedge (vismodegib capsules - Genentech/Roche) — Cigna
Central Nervous System Cancer (medulloblastoma)
Initial criteria
- Patient is age ≥ 18 years
- Patient has medulloblastoma
- Patient has tried at least one chemotherapy agent (examples include etoposide, carboplatin, cisplatin)
- According to the prescriber, the patient has a mutation of the sonic hedgehog pathway
Approval duration
1 year