Nubeqa (darolutamide) — United Healthcare
non-metastatic castration-resistant prostate cancer (nmCRPC)
Initial criteria
- Diagnosis of prostate cancer
- AND one of the following: (a) Disease is non-metastatic AND castration-resistant OR (b) Disease is metastatic AND castration-sensitive
- AND one of the following: (a) Used in combination with a gonadotropin-releasing hormone (GnRH) analog [e.g., Lupron (leuprolide), Zoladex (goserelin), Trelstar (triptorelin), Vantas (histrelin), Firmagon (degarelix)] OR (b) Patient has had a bilateral orchiectomy
- For patients less than 19 years of age: Patient is less than 19 years of age OR NCCN Compendium indication with Category of Evidence and Consensus 1, 2A, or 2B
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Nubeqa therapy
Approval duration
12 months