Altuviiio — Medica

Hemophilia A

Initial criteria

Altuviiio is being used in at least ONE of the following scenarios: routine prophylaxis OR on-demand treatment and control of bleeding episodes OR perioperative management of bleeding
Factor VIII inhibitor testing has been performed within the past 30 days AND patient does not have a positive test for Factor VIII inhibitors ≥ 1.0 Bethesda units/mL OR patient has not received Factor VIII therapy in the past
Medication is prescribed by or in consultation with a hemophilia specialist

Altuviiio is being used in at least ONE of the following scenarios: routine prophylaxis OR on-demand treatment and control of bleeding episodes OR perioperative management of bleeding
Factor VIII inhibitor testing has been performed within the past 365 days AND patient does not have a positive test for Factor VIII inhibitors ≥ 1.0 Bethesda units/mL OR according to the prescriber, the patient does not have clinical manifestations suggesting the presence of Factor VIII inhibitors (such as bleeding not well controlled, decreased responsiveness to Factor VIII therapy, or expected Factor VIII activity levels not achieved)
Medication is prescribed by or in consultation with a hemophilia specialist

1 year