Ibtrozi (taletrectinib) — Highmark
ROS1-positive non-small cell lung cancer (NSCLC)
Initial criteria
- Age ≥ 18 years AND diagnosis of locally advanced or metastatic NSCLC (ICD-10: C34) AND disease is ROS1-positive
Reauthorization criteria
- Prescriber attests that member is tolerating therapy AND has experienced disease improvement OR delayed disease progression
Approval duration
up to 2 years