Kidney Cancer:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: Yes
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: Payer Specific
Supporting Documentation Requirements: Histology
ECOG Score Requirement Included in Policy: <= 2
Policy Includes Reference to Coverage for Non Clear Cell Histology: No
If Non-Clear Cell Histology is Referenced in Policy is There a Trial and Failure Requirement: No
Concomitant Use With: Inlyta

Merkel Cell Carcinoma:
Age Requirement: >= 12
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: 1 of AHFS Guidelines;Clinical Pharmacology;FDA Approved Indications;NCCN Guidelines
Diagnosis Types: 3 of Merkel Cell Carcinoma;metastatic;No previous therapy with a programmed death (PD-1/PD-L1)-directed therapy

Urothelial/Bladder Cancer:
Duration: 1 year(s)
Documented Diagnosis: Yes
Medical Test Required: No
Reauthorization Required: No
Duration of Reauthorization: N/A
Drug Policy Based On: 1 of NCCN Guidelines;Payer Specific
Diagnosis Types: 3 of As monotherapy;disease progression after platinum based chemotherapy;Locally advanced or metastatic urothelial carcinoma;No previous therapy with a programmed death (PD-1/PD-L1)-directed therapy;Progression within 12 mos. of neoadjuvant or adjuvant treatment with platinum-containing regimen;Subsequent therapy after previous platinum treatment
ECOG Score Requirement Included in Policy: <= 2
Individual cannot have a diagnosis of any of the following: 1 of Active immune-mediated disease;Disease progression while on or following PD-1/PD-L1 therapy;Require systemic immunosuppression