cancer chemotherapy medications — Highmark

treatment of cancer (including off-label indications recognized in specified reference compendia)

Initial criteria

Requested product is an FDA-approved federal legend product
Drug being requested is classified as a cancer chemotherapy medication
Chemotherapy drug is recognized for the treatment of the specific type of cancer for which it has been prescribed in at least one of the following reference compendia: American Hospital Formulary Service-Drug Information (AHFS-DI), National Comprehensive Cancer Networks (NCCN) Drugs and Biologics Compendium, Micromedex DRUGDEX, Elsevier Gold Standard’s Clinical Pharmacology, other authoritative compendia identified by the Federal Secretary of Health and Human Services or CMS, or recommended by review article or editorial comment in a major peer reviewed professional journal

12 months