Jesduvroq (daprodustat) — United Healthcare

anemia due to chronic kidney disease (CKD) in adults receiving dialysis for at least four months

Preferred products

Diagnosis of anemia due to chronic kidney disease (CKD)
AND Patient has been receiving dialysis for at least four months
AND Ferritin greater than 100 mcg/L
AND Transferrin saturation (TSAT) greater than 20%
AND Hemoglobin level less than 11 g/dL
AND Trial and failure, contraindication, or intolerance to an erythropoietin stimulating agent (ESA) [e.g., Aranesp (darbepoetin), Epogen (epoetin alfa), Procrit (epoetin alfa), Retacrit (epoetin alfa-epbx)]
AND Prescribed by or in consultation with a hematologist or nephrologist

Documentation of positive clinical response to Jesduvroq therapy (e.g., clinically meaningful increase in hemoglobin level)
AND Ferritin greater than 100 mcg/L
AND Transferrin saturation (TSAT) greater than 20%
AND Hemoglobin level does not exceed 12 g/dL
AND Patient is not on concurrent treatment with an erythropoietin stimulating agent (ESA) [e.g., Aranesp (darbepoetin), Epogen (epoetin alfa), Procrit (epoetin alfa), Retacrit (epoetin alfa-epbx)]
AND Prescribed by or in consultation with a hematologist or nephrologist

12 months