Skip to content
The Policy VaultThe Policy Vault

Kisqali (ribociclib)United Healthcare

Advanced, recurrent, or metastatic breast cancer

Preferred products

  • anastrozole
  • letrozole
  • exemestane
  • Faslodex (fulvestrant)

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:
  • Used in combination with an aromatase inhibitor (e.g., anastrozole, letrozole, exemestane) OR Used in combination with Faslodex (fulvestrant)

Reauthorization criteria

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

Approval duration

12 months