Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.
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caplacizumab

caplacizumab
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Cablivi INJECTION, INJECTABLE 11 mg        
Comments:

Referred to High Value Care Committee

P&T Recommendation: Formulary, restricted to oncology/hematology use in resistant aTTP patients – may need to be used as inpatient. Notify member of pharmacy administration if ordered for inpatient. For outpatient, use is restricted to PAP use and use of patients own medication from specialty pharmacy.

 

Reviewed: January 2020 (P&T)

Last updated: Oct. 9, 2020






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