Romiplostim (Nplate)

Evicore covers romiplostim (Nplate) for FDA‑approved chronic immune thrombocytopenia after inadequate response to corticosteroids, IVIG or splenectomy, and for compendial use in thrombocytopenia due to low‑ to intermediate‑risk myelodysplastic syndrome; therapy that does not meet these criteria is not approved. Coverage requires hematologist (or hematologist/oncologist for MDS) involvement, platelet counts <30×10^9/L (or <50×10^9/L with increased bleeding risk), prior therapy or splenectomy for ITP (or documented MDS risk category), adherence to dosing limits (≤10 mcg/kg SC weekly for ITP; ≤1,500 mcg SC up to twice weekly for MDS), initial approval up to 3 months and reauthorization only with documented beneficial platelet response (renewals up to 1 year).

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