Oncology Medications Policy

This eviCore policy covers FDA‑approved medications for direct cancer treatment and specified supportive‑care classes (e.g., hematopoietic growth factors, antiemetics, bone‑modifying agents) as medically necessary when consistent with NCCN Category 1/2A/2B recommendations or FDA indications, while non‑cancer uses and all hematopoietic stem cell transplantation–related medications are excluded. Most oncology and listed supportive‑care drugs require prior authorization unless specifically exempted in Section 1a/2a, and approvals require documentation of NCCN/FDA‑consistent indications and relevant clinical/pathologic/radiologic/genetic/molecular findings with atypical cases subject to physician review.

"All medications approved by the United States Food & Drug Administration (FDA) and used for the direct treatment of cancer are subject to governance within this document."