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What are the keytruda approval criteria for insurance?



Keytruda (pembrolizumab) is a medication used to treat various types of cancer. The approval criteria for insurance coverage of Keytruda can vary depending on the insurance provider and the specific cancer being treated.

Aetna, for example, provides coverage for Keytruda for certain types of cancer, including melanoma, non-small cell lung cancer, head and neck squamous cell carcinoma, classical Hodgkin lymphoma, urothelial carcinoma, and microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumors. However, coverage may be subject to certain conditions, such as prior authorization and medical necessity [2].

According to the Keytruda website, financial assistance may be available for eligible patients who meet certain criteria. This may include patients who are uninsured or underinsured, as well as those who have insurance but are experiencing financial hardship. Eligibility for financial assistance is determined on a case-by-case basis [3].

Drug Patent Watch provides information on the patent status of Keytruda but does not provide information on insurance coverage criteria [1].

In summary, the approval criteria for insurance coverage of Keytruda can vary depending on the insurance provider and the specific cancer being treated. Patients may need to meet certain conditions, such as prior authorization and medical necessity, and financial assistance may be available for eligible patients who meet certain criteria.

Sources:
[1] https://www.drugpatentwatch.com/p/biologics/tradename/KEYTRUDA
[2] https://www.aetna.com/cpb/medical/data/800_899/0890.html
[3] https://www.keytruda.com/financial-support/



Follow-up:   Which insurance plans cover Keytruda? What is the Keytruda dosage for insurance approval? Are there any age restrictions for Keytruda coverage?





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