Caprelsa

Drug - Caprelsa

August 2011

Therapeutic area - Oncology

FDA approved indication

The treatment of symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.

Criteria 

• Patient has been diagnosed with symptomatic or progressive medullary thyroid cancer with unresectable locally advanced or metastatic disease AND
• There is a cardiac monitoring plan AND
• The initial PA for the 300 mg tablet will allow a first fill of 14 days (14 tablets) with one refill to ensure patient tolerance with therapy before approving in larger, monthly quantities. The 100 mg tablet is available to allow for dose reduction in cases of patient's cardiovascular intolerance or severe toxicities, or if the patient has moderate to severe renal disease. The first fill of the 100 mg tablet is also subject to a 14 day first fill policy and the maximum quantity for the first 14 days is 28, to allow for a 200 mg/day dose. Subsequent fills will be limited to up to 68 tablets for the 100mg tablet and up to 34 tablets for the 300mg tablet

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411