Epoetin alfa (Epogen®, Procrit®, Retacrit®)

Epoetin alfa (Epogen/Procrit/Retacrit) is covered for anemia of chronic kidney disease (on dialysis and for non‑dialysis patients who meet specified Hb/iron criteria), zidovudine‑associated anemia in HIV patients, and to reduce allogeneic RBC transfusion for elective nonvascular, noncardiac surgery (not covered for vascular/cardiac or non‑elective procedures and only when the patient is unable/unwilling to donate autologous blood). Key requirements include meeting specified hemoglobin thresholds (e.g., <10 g/dL for many initial indications, ≤13.0 g/dL for surgical use, higher cutoffs for continuing ESA therapy as specified), documented adequate iron stores or current iron therapy, proof of current zidovudine or ESA use when applicable (or serum EPO ≤500 mU/mL if used for zidovudine anemia), and supporting labs/clinical documentation; approvals are limited to 1 month for preoperative use and 12 months for other indications.

"Anemia associated with chronic kidney disease (CKD) in individuals on dialysis"