Cotellic (cobimetinib) — United Healthcare
Melanoma
Preferred products
- Tafinlar (dabrafenib)
- Mekinist (trametinib)
Initial criteria
- Diagnosis of melanoma
- AND One of the following:
- - Patient has unacceptable toxicities to Tafinlar (dabrafenib) or Mekinist (trametinib) on the basis of agent side-effect profile OR
- - Disease is one of the following: relapsed > 3 months after treatment discontinuation, unresectable, or metastatic
- AND Disease is positive for one of the following mutations: BRAF V600E or BRAF V600K
- 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