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

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