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The Policy VaultThe Policy Vault

Granix (tbo-filgrastim)CareFirst (Caremark)

Primary prophylaxis of febrile neutropenia in members with solid tumors or non-myeloid malignancies receiving myelosuppressive anti-cancer therapy expected to cause ≥20% risk of febrile neutropenia, or 10–19% risk with additional risk factors, or <10% risk with ≥2 patient-related risk factors

Initial criteria

  • Authorization may be granted when all of the following are met:
  • 1. The requested medication will not be used in combination with other colony stimulating factors within any chemotherapy cycle.
  • 2. The member will not receive chemotherapy at the same time as radiation therapy.
  • 3. One of the following applies:
  • i. Primary prophylaxis: member is receiving myelosuppressive anti-cancer therapy expected to produce ≥20% risk of febrile neutropenia, or 10–19% risk with high-risk features (bone marrow compromise, comorbidities, other patient-specific risk factors), or <10% risk with at least 2 patient-related risk factors.
  • ii. Secondary prophylaxis: member experienced febrile neutropenia or dose-limiting neutropenia from prior chemotherapy cycle with same dose and schedule planned for current cycle.
  • iii. Treatment of high-risk febrile neutropenia: member has prognostic factors predictive of deterioration such as age >65 years or hospitalization at time of fever.

Approval duration

6 months