Ibrance (palbociclib) — United Healthcare

Initial criteria

• Diagnosis of advanced, recurrent, or metastatic breast cancer
• AND Disease is hormone-receptor (HR)-positive
• AND Disease is human epidermal growth factor receptor 2 (HER2)-negative
• AND One of the following: (a) Used in combination with an aromatase inhibitor (e.g., anastrozole, letrozole, exemestane) OR (b) Used in combination with Faslodex (fulvestrant)

Reauthorization criteria

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

Approval duration

12 months