Tazverik (tazemetostat) — Highmark
Epithelioid sarcoma (locally advanced or metastatic, not eligible for complete resection)
Initial criteria
- age ≥ 16 years
- diagnosis of epithelioid sarcoma (ICD-10: C49)
- disease classified as locally advanced or metastatic
- disease not eligible for complete resection
Reauthorization criteria
- prescriber attests member is tolerating therapy
- prescriber attests member has experienced a therapeutic response defined as disease improvement OR delayed disease progression
Approval duration
12 months