Nexavar — Highmark
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