Endari™
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
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411