Mulpleta — Blue Cross Blue Shield of Alabama

Initial criteria

• - Diagnosis of thrombocytopenia with chronic liver disease AND:
• • Platelet count <50×10^9/L
• • Scheduled for procedure with bleeding risk (e.g., GI endoscopy, liver biopsy, bronchoscopy, dental procedure)
• • Would require platelet transfusion unless platelet counts increase from baseline
• - OR another FDA labeled or compendia-supported indication for agent and route