Zejula (niraparib) — United Healthcare
Primary peritoneal cancer
Initial criteria
- Diagnosis of one of the following: Epithelial ovarian cancer OR Fallopian tube cancer OR Primary peritoneal cancer
- Disease is stage II-IV
- One of the following: Maintenance therapy for those who are in complete or partial response to platinum-based chemotherapy OR Recurrence therapy for platinum-sensitive disease in combination with bevacizumab
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Zejula therapy
Approval duration
12 months