Eribulin (Halaven)

Approved for: office administration

Indications for Prior Authorization

  • refractory metastatic breast cancer

The following indications do not meet the criteria for use established by the Western Health Advantage Pharmacy and Therapeutics Committee.

  • any other diagnosis not listed in the approved indications

All of the following must be met:

  • single drug therapy for the treatment of metastatic breast cancer
  • previous therapy with two National Comprehensive Cancer Network (NCCN) recommend chemotherapeutic regimens for the treatment of metastatic disease
  • patient has had therapy or has a contraindication to therapy with and anthracycline and a taxane

Dosing

The recommended dose is up to 1.4 mg/m2 IV on days one and eight of a 21 day cycle.

The drug is approvable for coverage for one year.

M:\Guidelines\WHA Injectable\eribulin (Halaven) 2011.doc


Western Health Advantage Pharmacy and Therapeutics Committee

Approved/Revised: May 2011 Reviewed: December 2013