Jesduvroq (daprodustat) — Medica
Anemia due to chronic kidney disease (CKD) in adults who are on dialysis
Initial criteria
- Patient is age ≥ 18 years; AND
- Patient has been receiving dialysis for at least 4 consecutive months; AND
- Patient meets ONE of the following (a or b):
- a) Patient meets BOTH of the following (1 and 2):
- (1) Patient is currently receiving an erythropoiesis-stimulating agent and transitioning to Jesduvroq; AND
- (2) Patient has a hemoglobin level ≤ 12.0 g/dL; OR
- b) Patient meets BOTH of the following (1 and 2):
- (1) Patient is NOT currently receiving an erythropoiesis-stimulating agent; AND
- (2) Patient has a baseline (prior to initiation of Jesduvroq) hemoglobin level < 11 g/dL; AND
- Patient meets ONE of the following (a or b):
- a) Patient is currently receiving iron therapy; OR
- b) According to the prescriber, patient has adequate iron stores; AND
- The medication is prescribed by or in consultation with a nephrologist.
Reauthorization criteria
- Patient is age ≥ 18 years; AND
- Patient has been receiving dialysis for at least 4 consecutive months; AND
- Patient has a hemoglobin level ≤ 12.0 g/dL; AND
- Patient meets ONE of the following (a or b):
- a) Patient is currently receiving iron therapy; OR
- b) According to the prescriber, patient has adequate iron stores; AND
- According to the prescriber, patient has experienced a response to therapy (e.g., increase or stabilization in hemoglobin levels or reduction/absence in red blood cell transfusions); AND
- The medication is prescribed by or in consultation with a nephrologist.
Approval duration
Initial: 6 months; Reauthorization: 1 year