Encorafenib (Braftovi ™)

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization: 
  • Indicated in combination with Mektovi® (binimetinib tablets), for the treatment of patients with unresectable or metastatic melanoma with a BRAF V600E or V600K mutation, as detected by an FDA approved test.

The following criteria must be met: 
  • Medication is prescribed by or in consultation with an oncologist, AND

  • Patient has unresectable, advanced, or metastatic melanoma, AND

  • Patient has melanoma with BRAF V600 mutation, AND

  • Braftovi will be used in combination with Mektovi® (binimetinib tablets)

Dosing:
  • 450 mg (six 75 mg capsules) orally taken once daily in combination with binimetinib until disease progression or unacceptable toxicity.

Approval: 

1 year

Last review date: August 27, 2019

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