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System Formulary Update
Andexxa Formulary Restriction

Situation

The formulary restriction proposal for Andexxa was approved at the July 2021 System Pharmacy and Therapeutics Committee meeting.

Background

Andexxa is a recombinant modified human factor Xa protein used when patients treated with apixaban or rivaroxaban require reversal of anticoagulation due to life-threatening or uncontrollable bleeding. Andexxa is the only emergency reversal agent approved for use in patients taking the direct-acting oral anticoagulants (DOACs), specifically apixaban and rivaroxaban. Although Andexxa was studied under a variety of conditions, the drug was largely studied in patients with intracranial hemorrhage and GI bleeds. It is also very expensive compared to other alternative evidence-based agents.

Based on thorough evaluation of historical use and engagement of key stakeholders across the system, Andexxa was approved by System P&T to be restricted to use only in intracranial hemorrhage.

 Assessment/Recommendation

Changes effective: Tuesday August 3, 2021

System P&T voted to restrict use only for treatment of intracranial hemorrhage from apixaban and rivaroxaban only.

Note: Stock of this product may vary at individual entities