Oncology - Verzenio Prior Authorization Policy
Cigna prior authorization policy for Verzenio (abemaciclib tablets) defining medical necessity criteria, approval durations, covered FDA indications (early breast cancer adjuvant; recurrent/metastatic breast cancer in women and men; recurrent/metastatic endometrial cancer with letrozole) and that other uses are considered experimental/investigational.
Annual Revision noted: 'No criteria changes.' for the 02/26/2025 review.
Coverage Summary
Cigna prior authorization policy for Verzenio (abemaciclib tablets) defining medical necessity criteria and approval durations. Covered indications include: Early (adjuvant) breast cancer (node-positive, high-risk) with approval duration of 2 years (total); Recurrent/metastatic breast cancer in women and men with approval duration of 1 year; and Recurrent/metastatic endometrial cancer for ER-positive tumors in combination with letrozole with approval duration of 1 year. Uses not specified in the FDA-approved indications or supported by the policy are considered experimental, investigational or unproven.
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