FLASCO Clinical Practice Committee – Making Strides for Patients

• FLASCO
• July 2, 2019
• Clinical Practice Updates, Drugs, News

Recently, the FLASCO Clinical Practice Committee Chairman and Co-Chairmen, sent a letter to FL Blue expressing FLASCO’s  support for Gilotrif coverage.

Last week Florida Blue provided the following response to FLASCO and we wanted to share this info with all members.

“First of all thanks for reaching out to us and sharing feedback from FLASCO.  It is always helpful in to get provider feedback regarding our policies.

In regards to your question,  at Florida Blue we defer to NCCN guidelines (evidence 2A or greater) for coverage policies for oncology and oncology related drugs.  This is the reason that our committees crafted the policy to require EGFR mutation confirmation for coverage of afatinib for NSCLC.  NCCN specifically states that in patients without an EGFR mutation, use of afatinib as second-line therapy is not recommended due to the safety and efficacy compared to other available agents.

However, after reading the content provided and noting that there are cases where other available agents are contraindicated or not appropriate, we will initiate a policy change to align with the FDA label to allow coverage for members with progression after platinum based chemotherapy but only in cases where other first and second line agents are unreasonable or contraindicated.  We will have to finalize the actual policy language with the intent will be to remain compliant with NCCN compendium and also the FDA label. 

We will initiate the policy change early next week and will share it with our reviewers to be put into their processes as soon as possible.  It may take up to 45 days to appear on our website.

Thanks again for the feedback as it is always appreciated.”