Skip to content
The Policy VaultThe Policy Vault

MirceraBlue Cross Blue Shield of Oklahoma

Anemia associated with chronic kidney disease (including ESRD)

Initial criteria

  • Prior to starting requested agent, iron stores evaluated (ferritin ≥ 100 ng/mL OR transferrin saturation ≥ 20%)
  • Iron stores maintained during therapy
  • Blood pressure adequately controlled and monitored before and during therapy
  • ESA dose is lowest sufficient to avoid need for RBC transfusion
  • For CKD: Hgb < 11 g/dL (or < 10 g/dL initiating)
  • Prescriber is specialist or has consult
  • No FDA labeled contraindications

Approval duration

12 months