Darbepoetin Alfa (Aranesp®)

Aranesp (darbepoetin alfa) is covered only for FDA‑approved anemia due to chronic kidney disease (CKD) — in patients on dialysis, not on dialysis, and pediatric CKD — and is excluded for non‑CKD or oncology‑related anemia. Coverage requires documentation of CKD‑related anemia and dialysis status as applicable, hemoglobin thresholds for initiation/continuation (adults initiating <10.0 g/dL; pediatrics ≤11.0 g/dL; adults already on an ESA <11.5 g/dL; pediatrics on an ESA ≤12.0 g/dL), evidence of adequate iron stores or current iron therapy for non‑dialysis patients, patient weight for mcg/kg dosing (IV preferred for hemodialysis), and approvals are issued for up to 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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