Alvaiz — Medica

Initial criteria

• Patient has low- to intermediate-risk myelodysplastic syndrome
• Patient has a platelet count < 30 x 10^9/L (< 30,000/mcL) OR BOTH of the following: platelet count < 50 x 10^9/L (< 50,000/mcL) AND increased risk for bleeding per prescriber
• Medication is prescribed by or in consultation with a hematologist or oncologist

Reauthorization criteria

• According to the prescriber, patient demonstrates a beneficial clinical response (e.g., increased or maintained platelet counts, or decreased frequency of bleeding episodes)
• Patient remains at risk for bleeding complications

Approval duration

3 months initial, 1 year reauthorization