Tarceva
| Covered Uses: | All FDA approved indications not otherwise excluded from Part D. Additional coverage for off-label use is provided for newly diagnosed glioblastoma multiforme |
| Exclusion Criteria: | |
| Required Medical Information: | Coverage is provided for treatment of pancreatic cancer when used in combination with gemcitabine. Coverage is provided for newly diagnosed glioblastoma multiforme when used in combination with temozolomide during and after radiotherapy. |
| Age Restrictions: | |
| Prescriber Restrictions: | |
| Coverage Duration: | 12 months |
| Other Criteria: |
Last Modified on 12/20/2012