Eltrombopag — Medica

Initial criteria

• age ≥ 6 years
• 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
• ONE of the following: (a) tried at least one other therapy (e.g., systemic corticosteroids, intravenous immunoglobulin, anti-D immunoglobulin, romiplostim, fostamatinib, avatrombopag, or rituximab) OR (b) undergone splenectomy
• prescribed by or in consultation with a hematologist

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