Retacrit — Blue Cross Blue Shield of Texas
Rare disease indication (BCBS NM Fully Insured or NM HIM members) or other FDA/compendia-supported off-label indication
Initial criteria
- Patient has no FDA labeled contraindications to requested agent
- For NM HIM or Fully Insured: indication is a rare disease and indication is FDA labeled or compendia supported
- For Ohio Fully Insured or HIM Shop: member resides in Ohio, plan is Fully Insured or HIM Shop, and indication is FDA labeled, compendia supported, or supported by two peer-reviewed journal articles showing safety and efficacy
Approval duration
12 months