Tazemetostat (Tazverik) (PDF)
Defines medical necessity criteria, approval durations, dosing limits, and documentation requirements for Tazemetostat (Tazverik) for epithelioid sarcoma and follicular lymphoma across Commercial, HIM, and Medicaid lines of business administered by Centene.
1Q 2026 annual review revised initial approval duration from 6 to 12 months and added requirement that requests do not exceed health plan-approved quantity limit, if applicable.
1Q 2025 annual review clarified EZH2-negative/unknown FL options and removed redirection to Aliqopa; added third-line therapy option.
1Q 2023 annual review clarified that ≥2 prior therapies applies to EZH2 mutation positive FL and adjusted options for EZH2-negative/unknown disease.
Revised approval duration for Commercial line of business to 12 months or duration of request, whichever is less (effective 01.20.22).
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.