Aranesp — Blue Cross Blue Shield of Texas
Anemia in cancer patients with non-myeloid metastatic malignancies receiving myelosuppressive chemotherapy
Initial criteria
- Prior to starting the requested agent, ferritin ≥ 100 ng/mL OR transferrin saturation ≥ 20%
- Iron stores maintained before and during ESA therapy
- Blood pressure adequately controlled before and during ESA therapy
- ESA dose is the lowest to avoid RBC transfusion need
- Prescriber is a nephrologist, oncologist, or has consulted with one
- Patient has no FDA labeled contraindications
Approval duration
12 months (CKD, MDS, HIV anemia); 6 months (chemotherapy anemia, other diagnoses)