Oncology Medications Policy

This policy covers FDA‑approved drugs for direct cancer treatment and specified supportive oncology classes (e.g., hematopoietic growth factors, antiemetics, bone‑modifying agents, otoprotectants) and recognizes NCCN Category 1/2A/2B recommendations or FDA indications as medical‑necessity standards, while uses unrelated to cancer or hematopoietic stem cell transplantation are excluded. Most oncology and supportive drugs require prior authorization unless explicitly listed as exempt, and eviCore’s coverage decisions depend on clinical documentation consistent with NCCN/FDA guidance (with delegated payer policies taking precedence).

"Bevacizumab use for the management of radiation induced necrosis symptoms is subject to governance within this document."

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