Alvaiz — Medica
Thrombocytopenia in a Patient with Myelodysplastic Syndrome
Initial criteria
- low- to intermediate-risk myelodysplastic syndrome
- ONE of the following: (a) platelet count < 30 x 10^9/L OR (b) platelet count < 50 x 10^9/L AND at increased risk for bleeding per prescriber
- prescribed by or in consultation with a hematologist or oncologist
Reauthorization criteria
- according to prescriber, patient demonstrates a beneficial clinical response (e.g., increased platelet counts, maintenance of platelet counts, and/or decreased frequency of bleeding episodes)
- patient remains at risk for bleeding complications
Approval duration
initial: 3 months; reauth: 1 year