Bevacizumab for Non-Ocular Indications

Bevacizumab and its biosimilars are covered for the listed non‑ocular oncology indications (e.g., intestinal-type ampullary adenocarcinoma, recurrent/metastatic breast cancer, a broad range of CNS tumors, persistent/recurrent/metastatic cervical/vaginal cancer, and colorectal/appendiceal/anal adenocarcinoma); indications not listed and bevacizumab combined with cetuximab or panitumumab are considered experimental/investigational and excluded. Precertification is required for all oncology uses, Mvasi (bevacizumab‑awwb) is the preferred agent so Avastin, Alymsys, Vegzelma, and Zirabev are only covered if Mvasi is contraindicated/intolerant/ineffective, and Alymsys/Mvasi/Vegzelma/Zirabev must not be given within 28 days of major surgery or until the wound is healed.

"Non-small cell lung cancer (NSCLC) – treatment of recurrent, unresectable, advanced, or metastatic non-squamous NSCLC"