Gefitinib (Iressa) clinical coverage policy
Defines medical necessity criteria, initial and continuation approval requirements, dosing limits, formulary/generic redirection, approval durations, and exclusions for gefitinib (Iressa) across Commercial, HIM, and Medicaid lines of business for treatment of NSCLC.
Annual reviews with no significant changes noted for multiple years; most recent P&T approval date 05.25 (2025) stating no significant changes.
2Q 2022 annual review added criterion for use as single-agent therapy for NSCLC and revised commercial approval durations.
2Q 2021 annual review added oral oncology generic redirection language.
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.