Serostim — Point32Health
Human immunodeficiency virus (HIV)-associated wasting or cachexia
Initial criteria
- Documented diagnosis human immunodeficiency virus (HIV)-associated wasting or cachexia
- Documentation of one (1) of the following: a. Unintentional weight loss of at least 10% from baseline OR b. Body mass index less than 20 kg/m2
- Documentation that other treatable causes of weight loss have been ruled out (e.g., depression, mycobacterium avium complex, chronic infectious diarrhea)
- Documentation the patient is concurrently receiving antiretroviral medications indicated for the treatment of human immunodeficiency virus (HIV)
Approval duration
24 months