topical retinoids — Point32Health

Initial criteria

• Effective treatment with such drug is recognized as a Medically Acceptable Indication according to NCCN Drugs and Biologics Compendium (Category 1 or 2A) OR by other Standard Reference Compendia OR supported by Peer-Reviewed Medical Literature recognized under the Sullivan Law
• Clinical documentation must support the drug's effectiveness in treating the intended malignancy, including applicable NCCN guideline(s)