Inrebic — Medical Mutual
Myelofibrosis, Intermediate-2 or high-risk, primary or secondary (post-polycythemia vera or post-essential thrombocythemia)
Initial criteria
- Prescribed by or in consultation with a hematologist or oncologist; AND
- Patient age ≥ 18 years; AND
- Thiamine (vitamin B1) levels and nutritional status will be assessed prior to initiating therapy and periodically during treatment; AND
- Baseline platelet count is ≥ 50 x 10^2/L; AND
- CBC with platelets, creatinine and BUN, hepatic panel, and amylase and lipase will be assessed at baseline and periodically during treatment; AND
- Patient is not currently using Jakafi (ruxolitinib) or will discontinue prior to initiation of Inrebic
Reauthorization criteria
- Extended approval is allowed for patients continuing therapy for indications previously approved
Approval duration
1 year