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Tagrisso (osimertinib tablets – AstraZeneca)Cigna

Non-Small Cell Lung Cancer – Post Tumor Resection, Adjuvant Therapy

Initial criteria

  • Patient age ≥ 18 years
  • Patient has completely resected disease
  • Patient has EGFR exon 19 deletion or exon 21 (L858R) substitution mutation as detected by an approved test
  • Patient meets ONE of the following (i or ii):
  • i. Patient had received previous adjuvant chemotherapy
  • ii. Patient is ineligible to receive platinum-based chemotherapy

Approval duration

3 years (total)