| Kaiser Foundation Health Plan Southern California |
| Lorbrena (lorlatinib) |
| Drugs for Cancer : Drugs for Cancer |
- Prior Authorization: Primary Biliary Cirrhosis and Hepatic Fibrosis:
Documented Diagnosis: Yes
Medical Test Required: Yes
Age Requirement: >= 18
Duration: 6 Month(s)
Reauthorization Required: Yes
- PA Applies
|