Eltrombopag — Cigna
Thrombocytopenia in a patient post-allogeneic transplantation
Initial criteria
- According to the prescriber, the patient has poor graft function
- Patient has a platelet count < 50 x 10^9/L (< 50,000/mcL)
- The medication is prescribed by or in consultation with a hematologist, an oncologist, or a stem cell transplant specialist physician
Reauthorization criteria
- According to the prescriber, the patient demonstrated a beneficial clinical response
Approval duration
3 months initial, 6 months continuation