Odomzo (sonidegib)
Indications for Prior Authorization
Odomzo (sonidegib)
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For diagnosis of Locally advanced basal cell carcinoma (BCC)
Indicated for the treatment of adult patients with locally advanced basal cell carcinoma (BCC) that has recurred following surgery or radiation therapy, or those who are not candidates for surgery or radiation therapy.
Criteria
Odomzo
Prior Authorization (Initial Authorization)
Length of Approval: 12 Month(s)
For diagnosis of Basal Cell Carcinoma
- Diagnosis of basal cell carcinoma AND
- Disease is locally advanced AND
- One of the following:
- Disease has recurred following surgery or radiation therapy
- Patient is not a candidate for surgery or radiation therapy
Odomzo
Prior Authorization (Reauthorization)
Length of Approval: 12 Month(s)
For diagnosis of Basal Cell Carcinoma
- Patient does not show evidence of progressive disease while on therapy
P & T Revisions
2025-09-12, 2024-08-07, 2023-09-01, 2023-07-18, 2022-09-08, 2021-09-17, 2021-05-21, 2020-08-10
References
- Odomzo Prescribing Information. Sun Pharmaceutical Industries, Inc. Cranbury, NJ. August 2023.
- 2. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version 1.2026 – September 2,2025. Accessed September 9 2025
- Per clinical consult with oncologist, February 11, 2021.
End Notes
- Verified with consultant that other specialists such as Dermatologists may prescribe sonidegib in addition to Oncologists. [3]
Revision History
- 2025-09-12: Annual Review - Verbiage and Background Changes
- 2024-08-07: 2024 Annual Review. Background changes.
- 2023-09-01: Annual Review - no criteria changes
- 2023-07-18: Removed oncologist specialist requirement
- 2022-09-08: Annual Review - No criteria updates
- 2021-09-17: 2021 annual review: no criteria changes.
- 2021-05-21: Addition of EHB formulary to guideline, no changes to criteria
- 2020-08-10: Annual Review - No changes
HEALTHY LIVING