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Bevyxxa

Drug - Bevyxxa® (betrixaban) [Portola Pharmaceuticals, Inc.]

September 2019

Therapeutic area - Anticoagulants

Approval criteria

  • Patient is ≥ 18 years old AND
  • Is hospitalized for an acute medical illness AND
  • Patient is not a candidate for one of the preferred agents (e.g., Xarelto or Pradaxa) AND
  • Meets one of the following criteria for increased risk of VTE in medical patients:
    • Age ≥ 55 years
    • Active Rheumatologic Diseases
    • Acute Myocardial Infarction
    • Cancer
    • Chemotherapy
    • Congestive Heart Failure class III or IV
    • Central venous catheters/Pulmonary artery catheters
    • Hemorrhagic cerebral vascular accident
    • Hormonotherapy
    • Hormone Replacement Therapy/Hormone Contraceptives
    • ICU admission
    • Ischemic cerebral vascular accident
    • Inflammatory bowel diseases
    • Infections
    • Nephrotic syndrome
    • Obesity
    • Paresis/paralysis of legs
    • Peripheral arterial insufficiency
    • Pregnancy and puerperium
    • Previous VTE
    • Reduced mobility
    • Severe respiratory diseases
    • Thrombophilias
    • Varices/chronic venous insufficiency

AND

  • Patient must NOT have any of the following:
    • An active bleed OR
    • Liver dysfunction OR
    • Severe renal insufficiency (CrCl 15 to 29 mL/min) and requires the concomitant use of a P-gp inhibitor OR
    • Prosthetic heart valve

Quantity limits

  • 43 capsules/42 days
  • 1 fill

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411

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