Serostim — United Healthcare

Initial criteria

• Diagnosis of HIV-associated wasting syndrome or cachexia
• Involuntary weight loss >10%
• Chronic diarrhea (2 loose stools/day >30 days) OR chronic weakness and fever
• Symptoms lasting ≥30 days (intermittent or constant)
• Absence of concurrent condition other than HIV that may cause these findings
• Nutritional evaluation completed since onset
• Optimized antiretroviral therapy

Reauthorization criteria

• Positive response to therapy (≥2% increase in body weight or body cell mass)
• One of the following goals not achieved: weight, body cell mass, BMI

Approval duration

3 months initial, 6 months reauthorization