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Balversa (erdafitinib)United Healthcare

Cholangiocarcinoma

Preferred products

  • Lytgovi (futibatinib)
  • Pemazyre (pemigatinib)

Initial criteria

  • Diagnosis of cholangiocarcinoma
  • Disease is one of the following: unresectable OR metastatic
  • Presence of FGFR2 genetic alterations
  • Disease has progressed on or after both of the following: Lytgovi (futibatinib) AND Pemazyre (pemigatinib)

Reauthorization criteria

  • Patient does not show evidence of progressive disease while on Balversa therapy

Approval duration

12 months