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RetacritCareFirst (Caremark)

Anemia due to cancer in patients undergoing palliative treatment

Initial criteria

  • Cancer with palliative treatment intent
  • Member assessed for iron deficiency anemia and has adequate iron stores (TSAT ≥ 20% within the prior 3 months) or receiving iron therapy

Reauthorization criteria

  • Current hemoglobin less than 12 g/dL
  • Documented response with rise in hemoglobin ≥ 1 g/dL after at least 12 weeks of therapy

Approval duration

12 weeks