• Adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer
• First-line treatment of postmenopausal women with hormone receptor positive or hormone receptor unknown locally advanced or metastatic breast cancer
• Treatment of advanced breast cancer in postmenopausal women with disease progression following tamoxifen therapy. Patients with Estrogen receptor-negative (ER-negative) disease and patients who did not respond to previous tamoxifen therapy rarely responded to Arimidex

• Adjuvant treatment of postmenopausal women with estrogen-receptor positive (ER positive) early breast cancer who have received two to three years of tamoxifen and are switched to Aromasin for completion of a total of five consecutive years of adjuvant hormonal therapy
• Treatment of advanced breast cancer in postmenopausal women whose disease has progressed following tamoxifen therapy

• Adjuvant treatment of postmenopausal women with hormone receptor positive early breast cancer
• Extended adjuvant treatment of postmenopausal women with early breast cancer who have received prior standard adjuvant tamoxifen therapy
• First and second-line treatment of postmenopausal women with hormone receptor positive or unknown advanced breast cancer

• Breast cancer or ductal carcinoma in situ (DCIS) in postmenopausal women
• Breast cancer prophylaxis in postmenopausal women at increased risk (Arimidex and Aromasin only)
• Male breast cancer
• Endometrial carcinoma
• Uterine sarcoma
• Ovarian Cancer
• Fertility (Femara only)
  • Member is female

AND

• Member has a fertility drug benefit

• Non-FDA approved indications, which are not listed in the Health Net Approved Indications and Usage Guidelines section, unless there is sufficient documentation of efficacy and safety in the published literature

• Combination therapy of aromatase inhibitors and human growth hormone to increase final adult height is considered investigational and not medically necessary
• Aromatase inhibitors are not covered to increase final adult height in children or adolescents with the following conditions:
• Small for Gestational Age (cosmetic)
• Idiopathic Short Stature (cosmetic)
• Constitutional delay of puberty (cosmetic)
• Precocious puberty (cosmetic)
• Use for male gynecomastia and breast tenderness associated with puberty is considered not medically necessary as the condition frequently resolves spontaneously
• Use for normalization of estrogen and testosterone levels in men, normalization of plasma lipids, or reduction of truncal or other fat is considered investigational and not medically necessary
• Per the National Comprehensive Cancer Network (NCCN) practice guidelines, men with breast cancer should be treated similarly to postmenopausal women, except that use of an aromatase inhibitor is ineffective without concomitant suppression of testicular steroidogenesis
• Arimidex, Aromasin, and Femara have NCCN practice guideline recommendations of category 2A for endometrial carcinoma
• Arimidex, Aromasin and Femara have NCCN practice guideline recommendations of category 2A for uterine sarcoma.
• Arimidex, Aromasin and Femara have NCCN practice guideline recommendations of category 2A for ovarian cancer (epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer). Additionally, Arimidex and Femara have NCCN practice guideline recommendations of category 2A for ovarian cancer (malignant sex cord-stromal tumors). Femara has a Micromedex recommendation of Class IIb for ovulation induction
• Arimidex and Aromasin have NCCN practice guideline recommendations of category 1 for prophylaxis of breast cancer in postmenopausal women at increased risk. Aromasin additionally has a Micromedex recommendation of Class I for this indication.