BAVENCIO (avelumab)

BAVENCIO (avelumab)

OFFICE ADMINISTRATION [medical benefit]

Indications for Prior Authorization:

• Treatment of adult and pediatric patients at least 12 years of age with metastatic Merkel cell carcinoma

Patients must meet the following criteria for the indication(s) above:

• Prescribed by an oncologist; AND
• Diagnosis of metastatic Merkel cell carcinoma; AND
• 12 years or older; AND
• Patient has tried and failed guideline recommended chemotherapy treatment regimen(s)

Dosing:

• 10 mg/kg IV infustion over 60 minutes once every 2 weeks
• Premedicate with an antihistamine and acetaminophen before the first four Bavencio infusions
• Dose modifications recommended based on adverse events

Approval:

• Initial: 3 months
• Renewal: 1 year