BlueCross BlueShield of Tennessee Medical Policy Manual

Abraxane® (paclitaxel, albumin-bound); paclitaxel, albumin-bound

IMPORTANT REMINDER

 

We develop Medical Policies to provide guidance to Members and Providers.  This Medical Policy relates only to the services or supplies described in it.  The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy.  For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed.  If there is a conflict between the medical policy and a health plan or government program (e.g., TennCare), the express terms of the health plan or government program will govern.

 

POLICY

INDICATIONS

The indications below including FDA-approved indications and compendial uses are considered a covered benefit provided that all the approval criteria are met and the member has no exclusions to the prescribed therapy.

FDA-Approved Indications

Metastatic Breast Cancer

Indicated for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated.

Non-Small Cell Lung Cancer

Indicated for the first-line treatment of locally advanced or metastatic non-small cell lung cancer, in combination with carboplatin, in patients who are not candidates for curative surgery or radiation therapy.

Adenocarcinoma of the Pancreas

Indicated for the first-line treatment of patients with metastatic adenocarcinoma of the pancreas, in combination with gemcitabine.

Compendial Uses

All other indications are considered experimental/investigational and not medically necessary.

COVERAGE CRITERIA

Breast Cancer

Authorization of 6 months may be granted for treatment of breast cancer when any of the following criteria are met:

Non-Small Cell Lung Cancer (NSCLC)

Authorization of 6 months may be granted for treatment of NSCLC when either of the following criteria are met:

Pancreatic Adenocarcinoma

Authorization of 6 months may be granted for treatment of pancreatic adenocarcinoma when used in combination with gemcitabine with or without cisplatin.

Ampullary Adenocarcinoma

Authorization of 6 months may be granted for treatment of ampullary adenocarcinoma in combination with gemcitabine.

Biliary Tract Cancers

Authorization of 6 months may be granted for treatment of biliary tract cancer in combination with gemcitabine when either of the following criteria are met:

Bladder Cancer

Authorization of 6 months may be granted for subsequent treatment of platinum-resistant locally advanced or metastatic bladder cancer.

Cervical Cancer

Authorization of 6 months may be granted for subsequent treatment of persistent, recurrent, or metastatic cervical cancer as a single agent.

Cutaneous Melanoma

Authorization of 6 months may be granted for subsequent treatment of metastatic or unresectable cutaneous melanoma as a single-agent or in combination with carboplatin. 

Endometrial Carcinoma

Authorization of 6 months may be granted for subsequent treatment of endometrial carcinoma as a single agent.

Epithelial Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer

Authorization of 6 months may be granted for treatment of epithelial ovarian cancer, fallopian tube cancer, and primary peritoneal cancer when either of the following criteria are met:

Kaposi Sarcoma

Authorization of 6 months may be granted for treatment of Kaposi sarcoma.

Small Bowel Adenocarcinoma

Authorization of 6 months may be granted for treatment of advanced or metastatic small bowel adenocarcinoma as a single agent or in combination with gemcitabine.

Uveal Melanoma

Authorization of 6 months may be granted for treatment of uveal melanoma as single-agent therapy for metastatic or unresectable disease.

Vaginal Cancer

Authorization of 6 months may be granted for subsequent treatment of recurrent or metastatic vaginal cancer as a single agent.

CONTINUATION OF THERAPY  

Authorization of 6 months may be granted for continued treatment in members requesting reauthorization for an indication listed in the coverage criteria section when there is no evidence of unacceptable toxicity or disease progression while on the current regimen.

MEDICATION QUANTITY LIMITS

Drug Name

Diagnosis

Maximum Dosing Regimen

Abraxane
(Paclitaxel Protein-Bound Particles)

Ampullary Adenocarcinoma

Route of Administration: Intravenous
125mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Biliary Tract Cancers: Intrahepatic Cholangiocarcinoma, Extrahepatic Cholangiocarcinoma, and Gallbladder Cancer

Route of Administration: Intravenous
125mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Bladder Cancer

Route of Administration: Intravenous
260mg/m²  every 3 weeks

Abraxane
(Paclitaxel Protein-Bound Particles)

Breast Cancer

Route of Administration: Intravenous
260mg/m²  on day 1 (21-day cycle)

125mg/m²  on days 1, 8, and 15 (28-day cycle)

125mg/m²  on days 1 and 8 (21-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Cervical Cancer

Route of Administration: Intravenous
125mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Cutaneous Melanoma

Route of Administration: Intravenous
150mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Endometrial Carcinoma

Route of Administration: Intravenous
260mg/m²  on day 1 (21-day cycle)

125mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Kaposi Sarcoma

Route of Administration: Intravenous
100mg/m²  on days 1, 8, and 15 (28-day cycle) for max 4 cycles

Abraxane
(Paclitaxel Protein-Bound Particles)

Non-Small Cell Lung Cancer (NSCLC)

Route of Administration: Intravenous
100mg/m²  on days 1, 8, and 15 (21-day cycle)

125mg/m²  on days 1, 8, and 15 (28-day cycle)

260mg/m²  on day 1 (21-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Ovarian, Fallopian, Primary Peritoneal Cancer

Route of Administration: Intravenous
260mg/m²  on day 1 (21-day cycle)

100mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Pancreatic Adenocarcinoma

Route of Administration: Intravenous
125mg/m²  on days 1, 8, and 15 (28-day cycle)

125mg/m²  on days 1 and 8 (21-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Small Bowel Adenocarcinoma

Route of Administration: Intravenous
125mg/m²  on days 1, 8, and 15 (28-day cycle)

260mg/m²  on day 1 (21-day cycle)

Abraxane
(Paclitaxel Protein-Bound Particles)

Uveal Melanoma

Route of Administration: Intravenous
150mg/m²  on days 1, 8, and 15 (28-day cycle)

Abraxane

(Paclitaxel Protein-Bound Particles)

 

Vaginal Cancer

Route of Administration: Intravenous

125mg/m²  on days 1, 8, and 15 (28-day cycle)

 

APPLICABLE TENNESSEE STATE MANDATE REQUIREMENTS

BlueCross BlueShield of Tennessee’s Medical Policy complies with Tennessee Code Annotated Section 56-7-2352 regarding coverage of off-label indications of Food and Drug Administration (FDA) approved drugs when the off-label use is recognized in one of the statutorily recognized standard reference compendia or in the published peer-reviewed medical literature.

ADDITIONAL INFORMATION 

For appropriate chemotherapy regimens, dosage information, contraindications, precautions, warnings, and monitoring information, please refer to one of the standard reference compendia (e.g., the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) published by the National Comprehensive Cancer Network®, Drugdex Evaluations of Micromedex Solutions at Truven Health, or The American Hospital Formulary Service Drug Information).

REFERENCES

  1. Abraxane [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; October 2022.
  2. paclitaxel, albumin-bound [package insert].Morgantown, WV: Mylan Institutional LLC; May 2024.   
  3. The NCCN Drugs & Biologics Compendium® © 2026 National Comprehensive Cancer Network, Inc. Available at: https://www.nccn.org. Accessed January 13, 2026.
  4. Lexi-Drugs. UpToDate Lexidrug. UpToDate Inc. https://online.lexi.com. Accessed January 14, 2026.

ORIGINAL EFFECTIVE DATE: 8/10/2013

MOST RECENT REVIEW DATE: 7/14/2026

ID_CHS_2026

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

This document has been classified as public information.