Zejula (niraparib) — United Healthcare

Initial criteria

• Diagnosis of castration-resistant distant metastatic (M1) prostate cancer
• Patient is positive for pathogenic BRCA1 or BRCA2 mutation
• Patient has not had treatment since disease progression to metastatic castration-resistant prostate cancer (mCRPC)
• One of the following: Patient has not received prior docetaxel and prior novel hormone therapy OR Patient had progression on prior docetaxel therapy and has not received prior novel hormone therapy OR Patient had progression on prior novel hormone therapy and has not received prior docetaxel therapy
• Used in combination with Yonsa (fine-particle abiraterone) and methylprednisolone

Reauthorization criteria

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

Approval duration

12 months