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System Formulary Update
Andexxa Formulary Restriction
January 1, 1970

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