Zelboraf (vemurafenib) — United Healthcare
Non-Small Cell Lung Cancer (NSCLC)
Initial criteria
- Diagnosis of non-small cell lung cancer (NSCLC)
- Disease is metastatic OR advanced OR recurrent
- Cancer is positive for BRAF V600E mutation
Reauthorization criteria
- Patient does not show evidence of progressive disease while on Zelboraf therapy
Approval duration
12 months