Jevtana (cabazitaxel)
Indications for Prior Authorization
Jevtana (cabazitaxel)
-
For diagnosis of Prostate Cancer
Indicated in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer previously treated with a docetaxel-containing treatment regimen.
Criteria
Jevtana
Prior Authorization (Initial Authorization)
Length of Approval: 12 Month(s)
- All of the following:
- Diagnosis of metastatic castration-resistant prostate cancer AND
- Used in combination with prednisone AND
- Patient has been previously treated with a docetaxel-containing regimen
Jevtana
Prior Authorization (Reauthorization)
Length of Approval: 12 Month(s)
- Patient does not show evidence of progressive disease
P & T Revisions
2024-03-05, 2023-06-22, 2022-03-08, 2021-09-27, 2021-05-19, 2021-02-21, 2020-02-12
References
- Jevtana Prescribing Information. Sanofi-Aventis U.S. LLC, Bridgewater, NJ. July 2023.
Revision History
- 2024-03-05: 2024 Annual Review. No criteria changes. Background updates.
- 2023-06-22: Removed specialist requirement
- 2022-03-08: Annual Review
- 2021-09-27: Addition of EHB formulary to guideline, no changes to criteria
- 2021-05-19: Addition of EHB formulary to guideline, no changes to criteria
- 2021-02-21: Annual Review - No Changes
- 2020-02-12: Annual Review - No Changes
HEALTHY LIVING