Kisqali — Cigna

Breast Cancer – Early

Initial criteria

Patient age ≥ 18 years
Patient has hormone receptor positive (HR+) [estrogen receptor positive (ER+) and/or progesterone receptor positive (PR+)] disease
Patient has human epidermal growth factor receptor 2 (HER2)-negative breast cancer
Patient has early breast cancer (stage II or III) at high risk of recurrence (any lymph node involvement OR tumor size >5 cm OR tumor size 2–5 cm with either grade 2 and high genomic risk or Ki-67 ≥ 20% OR grade 3 disease)
Kisqali will be used in combination with anastrozole, exemestane, or letrozole
Patient is a postmenopausal woman OR a pre/perimenopausal woman receiving ovarian suppression/ablation with a gonadotropin-releasing hormone (GnRH) agonist OR has had surgical bilateral oophorectomy or ovarian irradiation OR is a man receiving a GnRH analog

3 years