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NexavarHighmark

differentiated thyroid carcinoma

Preferred products

  • sorafenib (generic)

Initial criteria

  • age ≥ 18 years
  • for RCC: advanced RCC (ICD-10: C64)
  • for hepatocellular carcinoma: unresectable (ICD-10: C22)
  • for thyroid carcinoma: locally recurrent or metastatic, progressive, differentiated type, refractory to iodine (ICD-10: C73)
  • if brand Nexavar requested: member has experienced therapeutic failure or intolerance to generic sorafenib

Reauthorization criteria

  • prescriber attests member is tolerating therapy and has experienced therapeutic response (disease improvement or delayed disease progression)
  • for brand Nexavar: experienced therapeutic failure or intolerance to generic sorafenib

Approval duration

12 months