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Gavreto (pralsetinib)Highmark

metastatic RET fusion-positive non-small cell lung cancer (NSCLC)

Initial criteria

  • age ≥ 18 years
  • diagnosis of NSCLC (ICD-10: C34)
  • disease is metastatic
  • disease is RET fusion-positive as detected by an FDA approved test

Reauthorization criteria

  • prescriber attests that member is tolerating therapy AND has experienced a therapeutic response defined as disease improvement OR delayed disease progression

Approval duration

12 months