UnitedHealthcare
Mekinist (trametinib)
Drugs for Cancer : Drugs for Cancer
  • Quantity Limit: limit maximum 1 EA PER 1 day(s)
  • Orally administered anticancer medication.
  • Prior Authorization: Melanoma (MEL):
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

    NSCLC with BRAF Mutation:
    Documented Diagnosis: Yes
    Age Requirement: < 19
    Duration: 12 Month(s)
    Reauthorization Required: Yes

    Thyroid Carcinoma:
    Duration: 12 Month(s)

    Uveal Melanoma:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

  • Melanoma (MEL):
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

    NSCLC with BRAF Mutation:
    Age Requirement: < 19
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

    Thyroid Carcinoma:
    Duration: 12 Month(s)

    Uveal Melanoma:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)