ALUNBRIG (brigatinib)

ALUNBRIG (brigatinib)

SELF ADMINISTRATION - ORAL

Diagnosis considered for coverage:

Non-small cell lung cancer (NSCLC): Indicated for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) as detected by an FDA-approved test.

Coverage Criteria:

For diagnosis of non-small cell lung cancer:

• Dose does not exceed 180 mg per day, AND

• Prescribed by or in consultation with an oncologist, AND

• The patient has metastatic non-small cell lung cancer, AND

• Patient has an anaplastic lymphoma kinase (ALK)-positive tumor as detected with an FDA-approved test or a test performed at a facility approved by Clinical Laboratory Improvement Amendments (CLIA)

Reauthorization Criteria:

• Patient does not show evidence of progressive disease while on therapy

Coverage Duration: 

• Initial: 12 months

• Reauthorization: 12 months

Authorization is not covered for the following:

The use of this drug for indications not listed in this policy does not meet the coverage criteria established by the Western Health Advantage (WHA) Pharmacy and Therapeutics (P&T) Committee. 

Additional Information: 

• Dosing

  • 90 mg orally once daily for the first 7 days;

  • If 90 mg is tolerated during the first 7 days, increase the dose to 180 mg orally once daily

  • If treatment with Alunbrig is interrupted for 14 days or longer for reasons other than adverse reactions, resume treatment at 90 mg once daily for 7 days before increasing to the previously tolerated dose

Policy Updates:
 

• 05/16/2023 – Updated indication and coverage criteria. 

References:

• Alunbrig Prescribing Information. Takeda Pharmaceuticals America, Inc. Lexington, MA. February 2022. 

• National Comprehensive Cancer Network (NCCN) Non-small cell lung cancer guideline. v.3.2022. Available at: http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed April 28, 2022.