Detailed, evidence-based regimens
Enhance quality and value in cancer care when you treat patients using therapies associated with better clinical outcomes. Optum® Oncology Pathways are detailed, evidence-based regimens selected through rigorous evaluation for specific cancer types and stages. These pathways are currently used in support of 27 million members.*
Regimens are based on a comprehensive literature review of all National Comprehensive Cancer Network (NCCN) recommended regimens.
Key benefits
Selecting a regimen
Regimens are based on efficacy, safety/toxicity and drug cost. We also consider claims data for the duration of therapy, hospitalization rates and total cost of care.
Program details
Pathway selection is not needed to receive prior authorization for therapy. Our criteria for determining cancer therapies coverage will not change because of this program.
Participating physicians
Our program is not a substitute for the judgment of a physician or other healthcare professional. Care decisions are between the physician and the patient.
Experts evaluate each pathway
The Optum Oncology Advisory Committee and disease-specific expert consultants evaluate each pathway. Committee members are selected for their clinical expertise to help ensure diverse perspectives. Members include practicing medical oncologists from academic medical centers and community oncology practices who are not employed by Optum Health.
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