Vafseo (vadadustat) — Medica

Initial criteria

• Patient is ≥ 18 years of age
• Patient has been receiving dialysis for at least 3 consecutive months
• EITHER: (a) Patient is currently receiving an erythropoiesis-stimulating agent and transitioning to Vafseo AND patient has a hemoglobin level ≤ 12.0 g/dL; OR (b) Patient is not currently receiving an erythropoiesis-stimulating agent AND has a baseline hemoglobin level < 11 g/dL
• EITHER: Patient is currently receiving iron therapy OR prescriber attests patient has adequate iron stores
• Medication is prescribed by or in consultation with a nephrologist

Reauthorization criteria

• Patient is ≥ 18 years of age
• Patient has been receiving dialysis for at least 3 consecutive months
• Patient has a hemoglobin level ≤ 12.0 g/dL
• EITHER: Patient is currently receiving iron therapy OR prescriber attests patient has adequate iron stores
• According to the prescriber, patient has experienced a response to therapy (e.g., increase or stabilization in hemoglobin levels or reduced/absent red blood cell transfusions)
• Medication is prescribed by or in consultation with a nephrologist

Approval duration

Initial: 6 months; Reauthorization: 1 year