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Nypozi (filgrastim-aafi)CareFirst (Caremark)

Chronic Myeloid Leukemia with persistent neutropenia due to tyrosine kinase inhibitor therapy

Preferred products

  • Neupogen
  • Zarxio
  • Nivestym
  • Granix
  • Releuko

Initial criteria

  • Diagnosis is an FDA-approved or medically accepted indication as listed above
  • Used for prevention or treatment of neutropenia or febrile neutropenia associated with chemotherapy or other listed conditions
  • For prophylaxis: patient receiving myelosuppressive chemotherapy regimen with ≥20% risk of febrile neutropenia or regimen with 10–19% risk plus at least one patient risk factor (per Appendix A–C)
  • For treatment: member has neutropenia complicated by infection (e.g., sepsis syndrome, invasive fungal infection, pneumonia or other documented infection), prolonged or profound neutropenia, or history of febrile neutropenia
  • Prescriber is an oncologist, hematologist, or infectious disease specialist or under their supervision

Reauthorization criteria

  • Member continues to meet initial authorization criteria
  • Clinical benefit is demonstrated with continued therapy

Approval duration

6 months