osimertinib — United Healthcare
Non-Small Cell Lung Cancer (NSCLC)
Initial criteria
- Diagnosis of non-small cell lung cancer (NSCLC)
- Disease is positive for at least one of the following EGFR mutations: Exon 19, Exon 21 L858R, S768I, L861Q, G719X, or T790M
- One of the following:
- a) All of the following: disease is stage IB, II, IIIA, or IIIB (T3, N2); patient has undergone complete resection; patient has received previous adjuvant chemotherapy or ineligible to receive platinum-based chemotherapy
- OR b) All of the following: disease is stage II–III; disease is locally advanced or unresectable; no disease progression during or following concurrent or sequential chemoradiation
- OR c) Disease is recurrent, advanced, or metastatic
Reauthorization criteria
- Documentation of positive clinical response to Tagrisso therapy
Approval duration
12 months