Rubraca (rucaparib) — United Healthcare
Fallopian tube cancer
Initial criteria
- Diagnosis of one of the following: epithelial ovarian cancer OR fallopian tube cancer OR primary peritoneal cancer
- Cancer has a deleterious BRCA mutation
- Used as maintenance therapy in individuals who are in complete or partial response to platinum-based chemotherapy
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Rubraca therapy
Approval duration
12 months