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AranespCareFirst (Caremark)

Anemia due to cancer in members undergoing palliative treatment

Initial criteria

  • Member has cancer and is undergoing palliative treatment for anemia
  • Member has been assessed for iron deficiency anemia and has adequate iron stores (TSAT ≥ 20% within the prior 3 months) or is receiving iron therapy
  • Member is not using other erythropoiesis-stimulating agents concomitantly

Reauthorization criteria

  • After at least 12 weeks of treatment, member has a rise in hemoglobin ≥ 1 g/dL
  • Current hemoglobin < 12 g/dL
  • Member continues to have cancer undergoing palliative treatment
  • Member has adequate iron stores (TSAT ≥ 20% within 3 months) or is receiving iron therapy
  • Member is not using other erythropoiesis-stimulating agents concomitantly

Approval duration

12 weeks