Promacta — Medica

Initial criteria

• Patient has low platelet counts at baseline (pretreatment)
• Patient had tried at least one immunosuppressant therapy OR will be using eltrombopag in combination with standard immunosuppressive therapy
• Medication is prescribed by or in consultation with a hematologist

Reauthorization criteria

• According to the prescriber, the patient demonstrates a beneficial clinical response (e.g., increased platelet counts, reduction in red blood cell transfusions, hemoglobin increase, or absolute neutrophil count increase)

Approval duration

initial: 4 months; reauth: 1 year