Caprelsa (vandetanib) — United Healthcare

Initial criteria

• Diagnosis of medullary thyroid cancer (MTC)
• ONE of the following: (a) Unresectable locoregional disease that is symptomatic or progressing OR (b) Asymptomatic recurrent or persistent distant metastatic disease if unresectable and progressing OR (c) Recurrent or persistent distant metastases if symptomatic disease or progression

Reauthorization criteria

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

Approval duration

12 months