Tisotumab Vedotin-tftv (Tivdak) (PDF)
Defines medical necessity criteria, initial and continuation approval criteria, dosing limits, covered diagnoses (FDA-approved and NCCN-off-label), exclusions, approval durations by line of business, coding implications and administrative requirements for Tivdak across Commercial, HIM and Medicaid lines.
Added allowance for combination use with Keytruda for PD-L1 positive cervical cancer per NCCN.
Added off-label vaginal cancer indication per NCCN.
Added Section III listing Diagnoses/Indications for which coverage is NOT authorized per current template.
Clarified single-agent requirement and removed prior restriction on number of prior systemic regimens.
Extended initial approval duration for HIM/Medicaid from 6 to 12 months.
Converted FDA approval for cervical cancer from accelerated to full approval per prescribing information.
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.