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Iressa

Drug - Iressa® (gefitinib) [AstraZeneca Pharmaceuticals LP]

May 2016

Therapeutic area - Oncology

Approval criteria

  • Patient must be 18 years of age or older AND
  • Must be prescribed for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) AND 
  • Tumor must have a known sensitizing EGFR mutation [Exon 19 deletion or Exon 21 (L858R) substitution] as detected by an FDA approved test (test results must be submitted at time of request)

Quantity limit

Maximum of 30 tablets per 30 days

Questions?

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

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