Qfitlia — Cigna

Hemophilia B with Factor IX Inhibitors

Initial criteria

Patient age ≥ 12 years; AND
Patient is using Qfitlia for routine prophylaxis to prevent or reduce the frequency of bleeding episodes; AND
Factor IX inhibitor titer testing has been performed within the past 30 days; AND
Patient has a positive test for Factor IX inhibitors of ≥ 0.6 Bethesda units/mL; AND
According to the prescriber, prophylactic use of bypassing agents will be discontinued no later than 7 days following the initial Qfitlia dose; AND
Patient is not undergoing immune tolerance induction therapy; AND
The medication is prescribed by or in consultation with a hemophilia specialist

Patient is using Qfitlia for routine prophylaxis to prevent or reduce the frequency of bleeding episodes; AND
According to the prescriber, prophylactic use of bypassing agents will not occur while receiving Qfitlia; AND
Patient is not undergoing immune tolerance induction therapy; AND
The medication is prescribed by or in consultation with a hemophilia specialist; AND
According to the prescriber, the patient experienced a beneficial response to therapy (e.g., reduction in bleeding events, severity, number requiring treatment, or spontaneous bleeds)

1 year