Augtyro (repotrectinib) — Highmark

Initial criteria

• For NSCLC: age ≥ 18 years AND diagnosis of locally advanced or metastatic NSCLC (ICD-10: C34) AND tumor is ROS1-positive
• For solid tumors: age ≥ 12 years AND diagnosis of solid tumors AND tumor harbors an NTRK gene fusion AND (disease is locally advanced or metastatic OR surgical resection likely to result in severe morbidity) AND (disease has progressed following treatment OR no satisfactory alternative treatments)

Reauthorization criteria

• Prescriber attests that member is tolerating therapy AND has experienced disease improvement OR delayed disease progression

Approval duration

up to 2 years