Health Net
Tazverik (tazemetostat)
Drugs for Cancer : Drugs for Cancer
  • Epithelioid Sarcoma:
    Age Requirement: >= 16
    Duration: 1 plan year
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Oncologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 plan year

    Follicular Lymphoma (FL):
    Age Requirement: >= 18
    Duration: 12 Month(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): 1 of Hematologist;Oncologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 12 month(s)

  • Prior Authorization: Epithelioid Sarcoma:
    Documented Diagnosis: Yes
    Age Requirement: >= 16
    Duration: 1 plan year
    Reauthorization Required: Yes

    Follicular Lymphoma (FL):
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 12 Month(s)
    Reauthorization Required: Yes