Feraheme® (Ferumoxytol) Approval Criteria:
- An FDA approved indication of 1 of the following:
- a. Iron deficiency anemia (IDA); or
- b. IDA with chronic kidney disease (CKD); and
- Documented lab results verifying IDA; and
- Documentation of intolerance or inadequate response to oral iron therapy after at least 3 months at recommended dosing; and
- Prescriber must verify the member does not have a previous history of allergic reaction to any intravenous iron medications; and
- A recent, failed trial of Infed® (iron dextran) or Venofer® (iron sucrose) or a patient-specific, clinically significant reason why the member cannot utilize Infed® and Venofer® must be provided.