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Epogen — Medica

any FDA-approved indication for erythropoiesis-stimulating agents

Preferred products

  • Procrit
  • Retacrit

Initial criteria

  • Patient meets the respective standard Erythropoiesis-Stimulating Agents Prior Authorization Policy criteria
  • Patient has tried at least one Preferred Product prior to approval of a Non-Preferred Product

Approval duration

3 years for patients with chronic kidney disease on dialysis; other durations per standard Erythropoiesis-Stimulating Agents Prior Authorization Policy