Romiplostim (Nplate)

Covered: romiplostim (Nplate) for chronic immune thrombocytopenia after inadequate response to corticosteroids, intravenous immunoglobulin, or splenectomy, and for thrombocytopenia in low‑ to intermediate‑risk myelodysplastic syndrome (compendial use); uses outside these FDA‑approved or stated compendial indications are not covered. Key requirements: prescriber must be a hematologist (or hematologist/oncologist for MDS) with documentation of prior therapy or splenectomy for ITP (or MDS risk classification and clinically significant thrombocytopenia such as platelets <30,000/µL, transfusion‑dependence, or bleeding), adherence to dosing limits (ITP ≤10 µg/kg SC once weekly; MDS ≤1,500 µg SC up to twice weekly), and approval is limited to 1 year with baseline and follow‑up documentation.

"Treatment of thrombocytopenia in individuals with chronic immune thrombocytopenia who had an insufficient response to corticosteroids, immunoglobulins, or splenectomy."