Gavreto (pralsetinib) — United Healthcare
Non-small cell lung cancer (NSCLC)
Initial criteria
- Diagnosis of non-small cell lung cancer (NSCLC)
- Disease is one of the following: recurrent OR advanced OR metastatic
- Presence of RET rearrangement positive tumors
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Gavreto therapy
Approval duration
12 months