Oncology Medications Policy

eviCore covers FDA‑approved cancer drugs and oncology medications listed in NCCN Guidelines with Categories 1, 2A, or 2B, plus specified supportive‑care drug classes when used per FDA indication, while excluding non‑cancer uses and most hematopoietic stem cell transplantation–related medication uses. Most oncology and supportive medications require prior authorization with documentation of diagnosis, regimen/treatment intent, NCCN category or FDA indication, and relevant clinical/pathologic/radiologic/genetic/molecular findings, though a specified list of exemptions (e.g., certain hormonal agents, oral antimetabolites, corticosteroids, generic antiemetics, and some bone‑modifying agents) do not require prior authorization.

"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."