UnitedHealthcare
Lynparza (Cap) (olaparib)
Drugs for Cancer : Drugs for Cancer
  • Breast Cancer: gBRCA, Metastatic Prostate Cancer, Pancreatic Cancer:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

    Ovarian Cancer:
    Duration: 12 Month(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)
    Drug Policy Based On: Payer Specific
    Diagnosis Types: 3 of advanced ovarian cancer;deleterious or suspected deleterious germline and/or somatic BRCA mutation;Disease progression on three or more prior lines of chemotherapy;epithelial ovarian, fallopian tube, or primary peritoneal cancer;maintenance treatment after a complete or partial response to platinum-based chemotherapy;persistent or recurrent disease

  • Prior Authorization: Breast Cancer: gBRCA, Metastatic Prostate Cancer, Pancreatic Cancer:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes

    Ovarian Cancer:
    Documented Diagnosis: Yes
    Duration: 12 Month(s)
    Reauthorization Required: Yes