Verzenio (abemaciclib tablets) — Cigna

Breast Cancer - Early

Initial criteria

Patient is 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 node-positive disease at high risk of recurrence
High risk includes patients with ≥ 4 positive lymph nodes, or 1-3 positive lymph nodes with grade 3 disease or tumor size ≥5 cm
Verzenio will be used in combination with anastrozole, exemestane, or letrozole AND patient meets ONE of the following: postmenopausal woman OR pre/perimenopausal woman receiving ovarian suppression/ablation with a GnRH agonist OR surgical bilateral oophorectomy/ovarian irradiation OR man receiving a GnRH analog; OR Verzenio will be used in combination with tamoxifen AND patient meets ONE of the following: postmenopausal woman or man OR pre/perimenopausal woman receiving ovarian suppression/ablation with a GnRH agonist OR surgical bilateral oophorectomy/ovarian irradiation

2 years