Gavreto (pralsetinib) — United Healthcare

Initial criteria

• One of the following:
• Both of the following: Diagnosis of gallbladder cancer AND disease is one of the following: unresectable OR resected gross residual (R2) OR metastatic
• OR Both of the following: Diagnosis of cholangiocarcinoma AND disease is one of the following: unresectable OR resected gross residual (R2) OR metastatic OR resectable locoregionally advanced
• Disease is positive for RET gene fusion mutation

Reauthorization criteria

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

Approval duration

12 months