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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

April 2018

New Prior Authorization Policy for Imfinzi


Harvard Pilgrim is covering the new-to-market drug Imfinzi with prior authorization for our commercial members. The FDA approved Imfinzi (durvalumab) in May 2017 for the treatment of patients with locally advanced or metastatic urothelial carcinoma.

Effective immediately, Harvard Pilgrim will cover Imfinzi with prior authorization for the treatment of locally advanced or metastatic urothelial carcinoma when any of the following criteria is met:

  • Member experienced disease progression during or following platinum-containing chemotherapy
  • Member experienced disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy

As a reminder, CVS Health–NovoLogix oversees our prior authorization program for medical drugs to optimize treatment outcomes and promote the safe and cost-effective use of these medications. To request authorization for Imfinzi, please contact CVS Health–NovoLogix via phone (844-387-1435) or fax (844-851-0882).

For complete information, please refer to our new Imfinzi Medical Review Criteria and the associated prior authorization request form

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Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator