Tbo-filgrastim injection (Granix)

Granix (tbo‑filgrastim) is covered to reduce severe neutropenia duration in non‑myeloid malignancies on myelosuppressive chemo and for prophylaxis/treatment of chemo‑induced febrile neutropenia (including AML post‑remission), for low‑risk myelodysplastic syndrome when given with epoetin/darbepoetin and EPO ≤500 mU/mL, and for mobilization of progenitor cells in allogeneic donors; it is not covered for routine use in myeloid malignancies (except specified AML use) and is contraindicated with a serious filgrastim/pegfilgrastim allergy. Coverage requires documentation of diagnosis, chemotherapy FN risk level (high ≥20% or intermediate 10–19% plus specified patient risk factors), relevant labs (ANC, EPO), timing relative to chemo (not within 24 hours before and ≥24 hours after), donor status for mobilization, adherence to NCCN infection‑risk criteria for treatment, safety monitoring, and approvals are limited to 180 days.

"Allergy history specifically documenting absence of serious allergic reaction to filgrastim or pegfilgrastim."