Braftovi (encorafenib) — United Healthcare

Initial criteria

• Diagnosis of colon or rectal cancer
• Presence of BRAF V600E mutation
• Disease is advanced OR metastatic
• EITHER (Patient has received prior therapy with an oxaliplatin-based regimen (e.g., FOLFOX, CAPEOX) AND Used in combination with Erbitux (cetuximab) OR Vectibix (panitumumab)) OR (Patient has not received prior therapy with an oxaliplatin-based regimen (e.g., FOLFOX, CAPEOX) AND Used in combination with BOTH Erbitux (cetuximab) OR Vectibix (panitumumab) AND FOLFOX (fluorouracil, leucovorin, and oxaliplatin))

Reauthorization criteria

• Patient does not show evidence of progressive disease while on Braftovi therapy
• Used in combination with one of the following: Erbitux (cetuximab) OR Vectibix (panitumumab) OR Erbitux (cetuximab) and FOLFOX (fluorouracil, leucovorin, and oxaliplatin) OR Vectibix (panitumumab) and FOLFOX

Approval duration

12 months