Aranesp — CareFirst (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