Cotellic (cobimetinib) — United Healthcare
Central Nervous System (CNS) Cancers
Initial criteria
- Diagnosis of one of the following: circumscribed glioma, glioblastoma, limited brain metastases, or extensive brain metastases
- AND Disease is BRAF V600E positive
- AND Used in combination with Zelboraf (vemurafenib)
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Cotellic therapy
- AND Used in combination with Zelboraf (vemurafenib)
Approval duration
12 months