Sutent — Cigna
Pancreatic neuroendocrine tumors that are progressive and well-differentiated in patients with unresectable locally advanced or metastatic disease
Preferred products
- generic sunitinib capsules
Initial criteria
- Patient meets the standard Oncology – Sunitinib Prior Authorization Policy criteria; AND
- Patient has tried generic sunitinib capsules [documentation required]; AND
- Patient cannot take sunitinib due to a formulation difference in the inactive ingredient(s) (e.g., difference in dyes, fillers, preservatives) between brand and bioequivalent generic product which, per the prescriber, would result in a significant allergy or serious adverse reaction [documentation required]
Approval duration
1 year