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Drug - Endari™ (L-glutamine oral powder) [Emmaus Medical Inc.]

February 2019

Therapeutic area - Sickle Cell Disease

Approval criteria

  • Patient must be at least 5 years of age AND
  • Patient has a diagnosis of sickle cell disease (SCD) AND
  • Patient has 2 or more painful crises within 12 months prior to request AND
  • Painful crises is defined as one of the following:
    • as a visit to an emergency room/medical facility for sickle cell-related pain which was treated with a parenterally administered narcotic or parenterally administered ketorolac OR
    • the occurrence of chest syndrome, priapism and splenic sequestration AND
  • Patient must not have any ONE of the following:
    • Pregnancy
    • Lactation
    • Renal or hepatic impairment

Quantity limits

  • 60 packets per 30 days


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

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