Ensacove (ensartinib) — United Healthcare
non-small cell lung cancer (NSCLC)
Preferred products
- Alecensa (alectinib)
- Alunbrig (brigatinib)
- Lorbrena (lorlatinib)
- Xalkori (crizotinib)
- Zykadia (ceritinib)
Initial criteria
- Diagnosis of non-small cell lung cancer (NSCLC)
- Tumor is anaplastic lymphoma kinase (ALK)-positive
- Disease is advanced OR metastatic OR recurrent
- Patient has not previously received an ALK-inhibitor (e.g. Alecensa [alectinib], Alunbrig [brigatinib], Lorbrena [lorlatinib], Xalkori [crizotinib], Zykadia [ceritinib]) OR patient is intolerant to or experiences disease progression on Xalkori (crizotinib)
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Ensacove therapy
Approval duration
12 months