LIBTAYO (cemiplimab-rwlc)

LIBTAYO (cemiplimab-rwlc)

OFFICE ADMINISTRATION

Indication for Prior Authorization:

• Indicated for the treatment of patients with metastatic cutaneous squamous cell carcinoma (CSCC) or locally advanced CSCC who are not candidates for curative surgery or curative radiation

Patients must meet the following criteria for the indication(s) above:

• Diagnosis of locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC) as confirmed by chart note documentation, AND
• Patient is not a candidate for curative surgery or curative radiation, AND
• Prescribed by or in consultation with an oncologist

Dosing:

• 350 mg as an intravenous infusion over 30 minutes every 3 weeks until disease progression or unacceptable toxicity

Approval:

• Initial: 6 months
• Renewal: 1 year