Mircera® (methoxy polyethylene glycol-epoetin beta) Injection

Mircera is covered for CKD‑related anemia in adults on dialysis and in adults not on dialysis who meet hemoglobin and iron criteria, and only for pediatric patients (3 months–17 years) when converting from another ESA after hemoglobin stabilization; it is not for ESA‑naïve pediatrics or pediatric doses <30 mcg (prefilled syringes cannot be partialed). Coverage requires documentation of CKD anemia and dialysis status, adequate iron stores or current iron therapy, age and weight for dosing, hemoglobin values (initial non‑ESA adults Hgb <10.0 g/dL; patients on ESA Hgb ≤12.0 g/dL; pediatric conversions must show prior hemoglobin stability), prior ESA history and total weekly dose for conversions, and prior route of administration for patients <6 years.

"Treatment of anemia associated with chronic kidney disease (CKD) in adult patients on dialysis."

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