Health Policy Affairs

On Nov. 5, 2025, SIR submitted comments to UnitedHealthcare Community Plan regarding its medical policy on transarterial radioembolization (TARE)/selective internal radiation therapy (SIRT) for the treatment of malignant cancers of the liver. We emphasized the clinical importance and growing body of evidence supporting the use of yttrium-90 (Y-90) radioembolization for patients with liver-dominant metastatic disease originating from primary tumors such as breast, pancreatic, prostate and lung cancers. While current data are primarily from non-randomized studies, extensive clinical experience, systematic reviews, meta-analyses and prospective multicenter studies consistently demonstrate the safety, efficacy and survival benefit of TARE in this population. Across these studies, Y-90 radioembolization consistently provides local tumor control, improved quality of life and extended survival in patients with chemorefractory or unresectable liver-dominant metastatic disease, offering a vital treatment option where systemic therapy alone is insufficient. We urge UnitedHealthcare to update its policy to ensure coverage of Y-90 TARE for select patients with breast, pancreatic, prostate and lung primary tumors who have liver-dominant disease, thereby promoting equitable access to care. SIR appreciates the opportunity to engage with UnitedHealthcare on this crucial issue and remains committed to advocating for evidence-based coverage policies that expand patient access to minimally invasive, image-guided cancer therapies.