Balversa (erdafitinib) — United Healthcare

Initial criteria

• Diagnosis of salivary gland tumor
• Disease is one of the following: recurrent OR unresectable OR metastatic
• Presence of FGFR genetic alterations
• Disease has progressed on or after at least one line of prior systemic therapy [e.g., platinum-based chemotherapy (e.g., cisplatin, carboplatin)]

Reauthorization criteria

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

Approval duration

12 months