Iressa (gefitinib) — Highmark
metastatic NSCLC
Preferred products
- gefitinib (generic)
Initial criteria
- age ≥ 18 years
- Diagnosis of metastatic NSCLC (ICD‑10: C34) AND disease harbors EGFR exon 19 deletion OR EGFR exon 21 (L858R) substitution mutation
- If brand Iressa requested, member has experienced therapeutic failure or intolerance to generic gefitinib