Darbepoetin Alfa (Aranesp)
EVICORE-MEDICAL_DRUG-7DD4F05B
Covers darbepoetin alfa (Aranesp) for anemia of chronic kidney disease in patients on or not on dialysis per the FDA-approved indication and excludes non–FDA-approved uses (including oncology-related anemia). Approvals require meeting age-specific hemoglobin thresholds for initial and continuation therapy (adults: initial Hgb <10.0 g/dL, continuation <11.5 g/dL; pediatrics: initial ≤11 g/dL, continuation ≤12 g/dL), documentation of iron therapy or adequate iron stores, weight- and dialysis-status–based per-dose mcg/kg and frequency limits, and are authorized for up to 12 months.
"Anemia associated with chronic kidney disease (CKD) in individuals on dialysis and individuals not on dialysis."
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