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Odomzo (sonidegib)United Healthcare

Diffuse basal cell carcinoma formation (e.g., Gorlin syndrome, other genetic forms of multiple BCC)

Initial criteria

  • Patient is less than 19 years of age OR
  • Diagnosis of nodal metastatic basal cell carcinoma OR
  • Diagnosis of diffuse basal cell carcinoma formation (e.g., Gorlin syndrome, other genetic forms of multiple BCC) OR
  • Diagnosis of locally advanced basal cell carcinoma AND one of the following: cancer has recurred following surgery; cancer has recurred following radiation; patient is not a candidate for surgery; patient is not a candidate for radiation
  • Drug is recognized for treatment of the cancer indication by the National Comprehensive Cancer Network (NCCN) Drugs and Biologics Compendium with a Category of Evidence and Consensus of 1, 2A, or 2B

Reauthorization criteria

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

Approval duration

12 months