Rubraca (rucaparib) — United Healthcare
Metastatic castration-resistant prostate cancer
Preferred products
- Zytiga (abiraterone)
- Xtandi (enzalutamide)
- Erleada (apalutamide)
Initial criteria
- Diagnosis of metastatic, castration-resistant prostate cancer
- Cancer has a deleterious BRCA mutation
- History of failure, contraindication, or intolerance to androgen receptor-directed therapy (e.g., Zytiga (abiraterone), Xtandi (enzalutamide), Erleada (apalutamide))
- Used in combination with a GnRH analog [e.g., Lupron (leuprolide), Zoladex (goserelin), Trelstar (triptorelin), Vantas (histrelin), Firmagon (degarelix)] OR patient has had bilateral orchiectomy
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Rubraca therapy
Approval duration
12 months