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The Policy VaultThe Policy Vault

Ibrance (palbociclib) — Medica

FDA-approved indications for hormone receptor positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative breast cancer in adults

Preferred products

  • Kisqali (ribociclib)
  • Kisqali Femara Co-Pack
  • Verzenio (abemaciclib)

Initial criteria

  • Patient meets the standard Prior Authorization Policy criteria for Ibrance
  • Patient has tried one of the Preferred Products (Kisqali, Kisqali Femara Co-Pack, or Verzenio) prior to approval of Ibrance