Pembrolizumab (Keytruda) - Medical Clinical Policy Bulletins

Pembrolizumab (Keytruda) is covered for specific cancers such as MSI-H or dMMR ampullary adenocarcinoma, metastatic anal carcinoma, CNS brain metastases in melanoma or PD-L1 positive non-small cell lung cancer, and cervical cancer under certain criteria. Key requirements include obtaining precertification and submitting the Statement of Medical Necessity, while limitations specify that it is not covered for pediatric patients with TMB-H CNS cancers or for patients whose disease progresses on prior PD-1 or PD-L1 inhibitors.

"Pembrolizumab is covered for certain malignancies as per Aetna''s clinical guidelines."

Sign up to see full coverage criteria, indications, and limitations.