Methoxy Polyethylene Glycol-Epoetin Beta (Mircera)

Covered: Mircera is covered for anemia of chronic kidney disease in adults (≥18 years, on dialysis or not) and in pediatric hemodialysis patients aged 5–17 only as a conversion from another ESA after hemoglobin stabilization; therapy is excluded for patients with uncontrolled hypertension or pure red cell aplasia after prior ESA exposure (no off‑label compendial uses approved). Key requirements: documented ferritin ≥100 mcg/L OR TSAT ≥20% OR supplemental iron, other causes of anemia ruled out/corrected, adults require pretreatment Hgb <10 g/dL to initiate and Hgb <12 g/dL plus ≥1 g/dL rise after ≥12 weeks for reauthorization, pediatric conversion requires documented stabilized Hgb, and approvals are limited to 6 months.

"Serum ferritin must be >= 100 mcg/L OR serum transferrin saturation (TSAT) must be >= 20% OR the individual must be receiving supplemental iron (applies to initial and reauthorization)."