Ensacove (ensartinib) — Highmark

Initial criteria

• age ≥ 18 years
• Diagnosis of locally advanced or metastatic NSCLC (ICD-10: C34)
• Disease is ALK-positive
• Member has not previously received an ALK-inhibitor

Reauthorization criteria

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

Approval duration

12 months