Oncology Medications Policy

eviCore deems medically necessary oncology and supportive-care drugs listed in NCCN Guidelines (Categories 1, 2A, 2B) or FDA‑approved for cancer indications, but excludes hematopoietic stem cell transplantation–related uses and non‑cancer indications. Most medications require prior authorization unless explicitly exempted in Sections 1a/2a, and non‑NCCN or exceptional uses must have individualized clinical review with supporting literature, guideline/FDA references and patient‑specific clinical, pathologic, radiologic, genetic or molecular data (plan-specific rules may supersede).

"Exempted Cancer Treatment Medications—Prior Authorization NOT Required: Antimicrobials: Doxycycline; Ketoconazole."

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