Tepmetko (tepotinib) — Highmark
metastatic non-small cell lung cancer (NSCLC) with MET exon 14 skipping alteration
Initial criteria
- age ≥ 18 years
- diagnosis of metastatic NSCLC (ICD-10: C33, C34)
- presence of MET exon 14 skipping alteration
Reauthorization criteria
- prescriber attests that the member is tolerating therapy
- therapeutic response defined as disease improvement OR delayed disease progression
Approval duration
12 months