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Hernexeos (zongertinib)Highmark

unresectable or metastatic non-squamous non–small cell lung cancer harboring HER2 (ERBB2) tyrosine kinase domain activating mutations

Initial criteria

  • age ≥ 18 years
  • diagnosis of unresectable or metastatic non-squamous non-small cell lung cancer (ICD-10: C34.90)
  • disease harbors HER2 (ERBB2) tyrosine kinase domain activating mutations, as detected by an FDA-approved test
  • member has received prior systemic therapy

Reauthorization criteria

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

Approval duration

12 months