Oncology Medications Policy

EviCore deems FDA‑approved cancer drugs and specified supportive‑care medication classes medically necessary when listed in NCCN Guidelines (Categories 1, 2A, 2B) or used per FDA indication, excludes stem cell transplant–related and non‑cancer uses, and exempts the specific drugs listed in Sections 1a and 2a from prior authorization. All other oncology/supportive meds require prior authorization with supporting clinical/pathologic/radiologic/genetic/molecular documentation, and any exceptions to NCCN need supporting references and individual clinical review (payer-specific delegated policies may supersede).

"All medications approved by the United States Food & Drug Administration (FDA) and used for the direct treatment of cancer."

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