Skip to content
The Policy VaultThe Policy Vault

Adstiladrin (nadofaragene firadenovec-vncg)Medica

high-risk Bacillus Calmette-Guerin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC) with high-grade papillary Ta/T1 tumors without CIS

Initial criteria

  • age ≥ 18 years
  • Patient has high-risk Bacillus Calmette-Guerin (BCG)-unresponsive disease
  • Patient meets ONE of the following: (a) carcinoma in situ (CIS); OR (b) high-grade papillary Ta/T1 tumors without CIS
  • Medication is prescribed by or in consultation with a urologist or an oncologist

Reauthorization criteria

  • Patient meets ONE of the following: (a) in remission both on cytology and cystoscopic examination; OR (b) cytology-positive, imaging- and cystoscopy-negative, recurrent or persistent disease
  • Medication is prescribed by or in consultation with a urologist or an oncologist

Approval duration

initial: 4 months; reauthorization: 3 months