Romiplostim (NPlate) "Notification"
New policy developed. Romiplostim (NPlate) may be considered medically necessary for the following clinical conditions: 1.Diagnosis of chronic idiopathic thrombocytopenia (ITP); and 2. platelet count ≤30 x 109/L), or upon start of therapy; and 3.history of trial and failure of; or a documented intolerance, FDA labeled contraindication, or hypersensitivity to corticosteroids or immunoglobulins (IVIg or anti-D); or 4. insufficient response to or is not a candidate for splenectomy. Medical director review 6/2016. Policy noticed 7/1/2016 for effective date 8/30/16.