Cablivi — Medical Mutual

Initial criteria

• Patient age ≥ 18 years; AND
• Cablivi was initiated in the inpatient setting, in combination with plasma exchange therapy; AND
• Patient is currently receiving at least one immunosuppressive therapy (e.g., systemic corticosteroids, rituximab [or a rituximab product], cyclosporine, cyclophosphamide, mycophenolate mofetil, hydroxychloroquine, bortezomib); AND
• If the patient has previously received Cablivi, he/she has not had more than two recurrences of acquired thrombotic thrombocytopenic purpura while on Cablivi; AND
• Cablivi is prescribed by, or in consultation with, a hematologist.

Approval duration

up to 60 days following the last plasma exchange session (one course of treatment)