Filgrastim injection (Neupogen)

Neupogen (filgrastim) is covered for specified FDA and compendial uses — prophylaxis/treatment of chemotherapy‑induced febrile neutropenia (limited to solid tumors/non‑myeloid malignancies or AML post‑remission with defined regimen risk or patient risk factors), hematopoietic stem cell mobilization (including donors), acute radiation syndrome, severe chronic/congenital neutropenia, MDS only when combined with epoetin alfa/darbepoetin alfa and serum EPO ≤500 mU/mL, and HIV‑associated neutropenia — and is not covered outside these criteria or in patients with a history of serious pegfilgrastim (Neulasta) allergy. Coverage requires documentation of the specific indication and risk/lab criteria, adherence to timing limits around chemotherapy (not within 24 hours before/after), mandated CBC/ANC monitoring and thresholds (e.g., stop donor mobilization if WBC >100,000/mm3; continue radiation treatment until ANC >1,000/mm3 for three consecutive CBCs or ANC >10,000/mm3), and approvals are limited to 180 days.