avatrombopag — United Healthcare

Initial criteria

• Diagnosis of chronic immune thrombocytopenia (ITP)
• AND Patient has had an insufficient response to a previous treatment (e.g., corticosteroids, immunoglobulins, thrombopoietin receptor agonists, splenectomy)

Reauthorization criteria

• Documentation of positive clinical response to Doptelet therapy

Approval duration

12 months