When services can be administered in various settings, the Company reserves the right to reimburse only those services that are furnished in the most appropriate and cost-effective setting that is appropriate to the member’s medical needs and condition. This decision is based on the member’s current medical condition and any required monitoring or additional services that may coincide with the delivery of this service.
This Medical Policy Bulletin document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy Bulletin will be reviewed regularly and be updated as scientific and medical literature becomes available. For more information on how Medical Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site.
American Hospital Formulary Service – Drug Information (AHFS-DI). [AHFS Website]. March 4, 2020. Available at: http://online.lexi.com/lco/action/doc/retrieve/docid/complete_ashp/3543686?cesid=00u0ET5qXea&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Djevtana%26t%3Dname%26va%3Djevtana#uses-nested-0 [via subscription only]. Accessed April 22, 2020.
Cabazitaxel (Jevtana®). Sanofi-Aventis US LLC, Bridgewater, NJ. 03/2020. Available at:
http://products.sanofi.us/jevtana/jevtana.html. Accessed April 22, 2020.
de Bono JS, Oudad M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resisitant prostate cancer progressing after docetaxel treatment: a randomised open-label. Lancet 2010; 376:1147-1154.
Lexi-Drugs Compendium. Cabazitaxel. [Lexicomp Online Web site]. 04/21/2020. Available at: http://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/2791319?cesid=8Wo8yLglAEE&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Djevtana%26t%3Dname%26va%3Djevtana [via subscription only]. Accessed April 22, 2020.
Micromedex® Healthcare Series. [Internet database]. Jevtana® (Cabazitaxel). April 16, 2020. Available at: https://www.micromedexsolutions.com/micromedex2/librarian/CS/61336E/ND_PR/evidencexpert/ND_P/evidencexpert/DUPLICATIONSHIELDSYNC/D2404D/ND_PG/evidencexpert/ND_B/evidencexpert/ND_AppProduct/evidencexpert/ND_T/evidencexpert/PFActionId/evidencexpert.GoToDashboard?docId=929642&contentSetId=100&title=Cabazitaxel&servicesTitle=Cabazitaxel&brandName=Jevtana# [via subscription only]. Accessed April 22, 2020.
National Cancer Institute (NCI). Prostate Cancer Treatment.[NCS Web site]. January 29, 2020. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/prostate/HealthProfessional. Accessed April 22, 2020.
National Comprehensive Cancer Network (NCCN). NCCN Drugs and Biologics Compendium. Cabazitaxel (Jevtana®). [NCCN Web site, subscription required.] Available at: https://www.nccn.org/professionals/drug_compendium/content/ Accessed April 22, 2020.
National Comprehensive Cancer Network (NCCN). NCCN Guidelines Clinical Practice Guidelines in Oncology: Prostate Cancer. V1.2020.[NCCN Web site, login required]. 02/21/17. Available at: https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf
Accessed April 22. 2020.
US Food and Drug Administration (FDA), Center for Drug Evaluation and Research. Clinical review #201023, Amy McKee, M.D. (Efficacy) and Ian Waxman, M.D. (Safety), March 2010. [FDA web site]. Available at: http://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/201023s000MedR.pdf.
Accessed April 22, 2020.
US Food and Drug Administration (FDA). Drug Approval package. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/201023s023lbl.pdf
Accessed April 22, 2020.
Policy: 08.00.95d:Personalized Vaccines (e.g. Provenge®)