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The Policy VaultThe Policy Vault

Ibrance — Medica

in combination with fulvestrant for disease progression following endocrine therapy

Preferred products

  • Kisqali
  • Kisqali Femara Co-Pack
  • Verzenio

Initial criteria

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