generic deferiprone — Medica

Transfusional iron overload due to sickle cell disease or other anemias

Initial criteria

For transfusion-related iron overload due to thalassemia syndromes: BOTH of the following (i and ii) must be met: i) Prior to starting chelating therapy, serum ferritin level was > 1,000 mcg/L [documentation required]; AND ii) The medication is prescribed by or in consultation with a hematologist.
For transfusion-related iron overload due to sickle cell disease or other anemias: BOTH of the following (i and ii) must be met: i) Prior to starting chelating therapy, serum ferritin level was > 1,000 mcg/L [documentation required]; AND ii) The medication is prescribed by or in consultation with a hematologist.
For non-transfusion-dependent thalassemia syndromes: BOTH of the following (i and ii) must be met: i) Prior to starting chelating therapy, serum ferritin level was > 300 mcg/L [documentation required]; AND ii) The medication is prescribed by or in consultation with a hematologist.

Patient is currently receiving deferiprone and is benefiting from therapy according to the prescriber (examples include reduction in serum ferritin levels, stable disease, or reduced organ iron load).

1 year