Pyrukynd (mitapivat) — United Healthcare
Pyruvate kinase (PK) deficiency with hemolytic anemia
Initial criteria
- Diagnosis of pyruvate kinase (PK) deficiency
- Used for the treatment of hemolytic anemia
Reauthorization criteria
- Documentation of positive clinical response to Pyrukynd therapy OR Documentation does not provide evidence of positive clinical response to Pyrukynd therapy, allow for dose titration with discontinuation of therapy
Approval duration
12 months (initial and reauthorization with positive response); 4 weeks (if reauthorization for dose titration without positive response)