Oncology Medications Policy

Covers oncology drugs for direct cancer treatment and specified supportive‑care classes when listed in NCCN Categories 1/2A/2B or FDA‑approved for the indication, excludes non‑cancer uses and all hematopoietic stem cell transplantation–related medication uses, and exempts certain drugs from prior authorization (e.g., listed hormonal agents, oral antimetabolites, specified corticosteroids, select NSAIDs/antimicrobials/antihypertensives, and listed antiemetics/bone‑modifying agents). All other cancer and supportive medications require prior authorization and must be supported by clinical documentation (diagnosis and pertinent pathologic/radiologic/genetic/molecular findings) showing consistency with NCCN or FDA indications, with off‑guideline uses reviewed case‑by‑case and requiring supporting literature.

"All other medication uses for the supportive treatment of cancer are outside the scope of this policy."