Romiplostim (Nplate)

Aetna covers romiplostim for ITP (after inadequate response/intolerance to corticosteroids, IVIG, or splenectomy and with pre‑treatment platelet <30 x10^9/L or 30–50 x10^9/L with symptomatic bleeding/risk), hematopoietic syndrome of acute radiation syndrome, myelodysplastic syndromes, and chemotherapy‑induced thrombocytopenia (platelets <100 x10^9/L for ≥3–4 weeks post‑chemo or chemo delayed), and excludes concomitant use with other thrombopoietin receptor agonists or SYK inhibitors and considers other indications (e.g., aplastic anemia, Evans syndrome, pregnancy thrombocytopenia, post‑allo SCT) investigational. Key requirements: ITP requires prior therapy failure/intolerance and specified platelet thresholds for initiation/continuation, therapy must show clinical benefit or meet target platelet ranges to continue, do not exceed 10 mcg/kg/week and discontinue if no response after 4 weeks at the maximum dose, do not use to normalize platelets and evaluate causes if response is lost.