Oncology Medications Policy

EviCore covers FDA‑approved medications for direct cancer treatment and specified supportive‑care classes when listed in NCCN Guidelines (Categories 1, 2A, or 2B) or used per FDA indication, and excludes hematopoietic stem cell transplantation–related uses and non‑cancer indications. Most drugs require prior authorization (with specified hormonal, certain antimetabolite, corticosteroid, NSAID, antimicrobial, antihypertensive, antiemetic, and some bone‑modifying agents exempted), and reviews rely on clinical/pathologic/radiologic/genetic information and physician consultation with case‑by‑case exceptions allowed.

"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."

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