Aranesp® (darbepoetin alfa) Injection Non-oncology

Covered: Aranesp is covered only for anemia due to chronic kidney disease (non‑oncology) in patients on dialysis and in non‑dialysis patients who meet policy criteria; non‑CKD or oncology uses are excluded. Key requirements: documentation of CKD and dialysis status, evidence of adequate iron stores or active iron therapy for non‑dialysis patients, hemoglobin <10.0 g/dL in adults (≥18 yrs) or ≤11.0 g/dL in patients <18 yrs for initial authorization (≤12.0 g/dL if already on an ESA), weight for dosing, IV preferred for hemodialysis, and approval is granted for 12 months.

"Aranesp is indicated for the treatment of anemia due to chronic kidney disease (CKD) in patients on dialysis and patients not on dialysis."

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