deferiprone — CareFirst (Caremark)

Initial criteria

• Phlebotomy is not an option (e.g., poor venous access, poor candidate due to underlying medical disorders) OR member had an unsatisfactory response to phlebotomy

Reauthorization criteria

• Member is experiencing benefit from therapy as evidenced by a decrease in serum ferritin levels as compared to pretreatment baseline

Approval duration

12 months