Lynparza (olaparib) — United Healthcare

Preferred products

• abiraterone
• GnRH analog
• steroids

Initial criteria

• Diagnosis of metastatic castration-resistant prostate cancer
• One of the following: (Presence of deleterious or suspected deleterious germline or somatic HRR gene mutations AND disease has progressed following prior treatment with enzalutamide or abiraterone) OR (Presence of deleterious or suspected deleterious BRCA mutation AND used in combination with abiraterone AND used in combination with steroids)
• One of the following: Used in combination with a GnRH analog OR patient has had bilateral orchiectomy

Reauthorization criteria

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

Approval duration

12 months