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Tavalisse — Point32Health

Immune thrombocytopenia

Initial criteria

  • Documented diagnosis of immune thrombocytopenia
  • Patient age ≥ 18 years
  • Prescribed by or in consultation with an appropriate specialist (e.g., hematologist, oncologist, immunologist, hepatologist, transplant specialist)
  • Documentation of one (1) of the following: baseline platelet count less than 30,000/mcL OR medical necessity for platelet elevation (e.g., upcoming surgery, peptic ulcer disease, or condition that may predispose the patient to bleeding)
  • Documented insufficient response or contraindication to ALL of the following: splenectomy, corticosteroids, immunoglobulins, Rituxan (rituximab), thrombopoietin receptor agonist (Promacta [eltrombopag], Nplate [romiplostim])