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Exjade — Medica

patients who meet the standard Chelating Agents – Iron Chelators (Oral) Prior Authorization Policy criteria

Preferred products

  • generic deferasirox tablets
  • generic deferasirox tablets for suspension
  • generic deferasirox granules
  • generic deferiprone tablets

Initial criteria

  • Patient meets the standard Chelating Agents – Iron Chelators (Oral) Prior Authorization Policy criteria; AND
  • Patient has tried ONE of generic deferasirox tablets, generic deferasirox tablets for suspension, generic deferasirox granules, or generic deferiprone tablets.

Approval duration

1 year