Health Net
Herzuma (Intravenous Solr) (Trastuzumab-Pkrb)
Drugs for Cancer : Drugs for Cancer
  • Breast Cancer: HR+ (HER2+):
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Oncologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

    Endometrial Cancer:
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Specialist Type(s): Oncologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

    Gastric Cancer:
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Specialist Required: Yes

  • Prior Authorization: Breast Cancer: HR+ (HER2+):
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

    Endometrial Cancer:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

    Gastric Cancer:
    Age Requirement: >= 18
    Duration: 6 Month(s)

  • Step Therapy: ST Multiple Brands

<< Return | Back to top