Oncology Medications Policy

eviCore covers oncology drugs listed in NCCN Guidelines (Categories 1, 2A, 2B) for direct cancer treatment and FDA‑approved supportive agents in the specified classes (myeloid growth factors, antiemetics, bone‑modifying agents, erythropoiesis‑stimulating agents, somatostatin analogues, tryptophan hydroxylase inhibitors) when used per NCCN or FDA indications, while uses related to hematopoietic stem cell transplantation, non‑cancer indications, and supportive therapies outside those classes are excluded. Most oncology and supportive medications require prior authorization unless explicitly exempted in the policy tables, and requests must reference the applicable NCCN category or FDA indication, include regimen and clinical documentation, with exceptions supported by peer‑reviewed evidence, other guidelines, FDA labeling, or expert peer consultation.

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