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Sevenfact — Blue Cross Blue Shield of New Mexico

All indications approved under Coagulation Factor VIIa criteria

Initial criteria

  • Quantity limit approval when ONE of the following are met:
  • 1. The requested quantity (dose) does NOT exceed the program quantity limit defined by BOTH:
  • A. The requested dose is within the FDA labeled dosing
  • AND
  • B. The quantity (number of doses) is appropriate based on intended use (e.g., on-demand, prophylaxis, perioperative)
  • OR
  • 2. There is support for exceeding the defined program quantity limit (dose and/or number of doses) with medical records provided

Approval duration

up to 12 months