Gilotrif (afatinib) — United Healthcare

Initial criteria

• Diagnosis of metastatic non-small cell lung cancer (NSCLC)
• AND One of the following: Squamous disease progressing after previous platinum-based chemotherapy OR Tumors are positive for non-resistant epidermal growth factor receptor (EGFR) mutations

Reauthorization criteria

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

Approval duration

12 months