Oncology Medications Policy

eviCore covers FDA‑approved medications for direct cancer treatment and specified supportive‑care classes when consistent with NCCN Categories 1, 2A, or 2B recommendations or FDA indications, but excludes non‑cancer uses and all therapies related to hematopoietic stem cell transplantation and supportive classes not listed. Most oncology and listed supportive drugs require prior authorization (specific exempted agents are identified as not requiring authorization), and uses outside NCCN/FDA guidance require clinical documentation, rationale, and physician review.

"All drugs used for direct treatment of cancer require prior authorization unless listed as exempted in the "Prior Authorization NOT Required" Section 1a."

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