Health Net
Xtandi (enzalutamide)
Drugs for Cancer : Drugs for Cancer
  • Age Requirement: >= 18
    Duration: 1 plan year
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Oncologist;Urologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 plan year

  • Health Net Approved Indications and Usage Guidelines: Diagnosis of metastatic castration-resistant prostate cancer AND For patients without visceral metastases: Failure or clinically significant adverse effects to Zytiga
  • Step Therapy: ST Single Brand

  • Anti-Cancer:Maximum $200 copayment per State Law.
  • Step Therapy Exists in PA
  • Prior Authorization: Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 1 plan year
    Reauthorization Required: Yes