Kerendia (finerenone) — Blue Cross Blue Shield of Kansas

Preferred products

• Product containing an ACE inhibitor
• Product containing an ARB
• Product containing a DPP-4
• Product containing a GLP-1
• Product containing an insulin
• Product containing metformin
• Product containing a SGLT2

Initial criteria

• Target Agent(s) will be approved when ONE of the following is met:
• 1. The requested agent is eligible for continuation of therapy AND ONE of the following:
• A. The patient has been treated with the requested agent (starting on samples is not approvable) within the past 180 days OR
• B. The prescriber states the patient has been treated with the requested agent (starting on samples is not approvable) within the past 180 days AND is at risk if therapy is changed
• OR
• 2. BOTH of the following:
• A. ONE of the following:
• 1. The patient has a medication history of use in the past 180 days, intolerance, or hypersensitivity to a product containing an ACE inhibitor or an ARB OR
• 2. The patient has an FDA labeled contraindication to ALL products containing an ACE inhibitor or an ARB
• AND
• B. ONE of the following:
• 1. The patient has a medication history of use in the past 180 days, intolerance, or hypersensitivity to a product containing a DPP-4, GLP-1, insulin, metformin, or SGLT2 OR
• 2. The patient has an FDA labeled contraindication to ALL products containing a DPP-4, GLP-1, insulin, metformin, or SGLT2

Reauthorization criteria

• Continuation of therapy eligibility if patient has been treated with the requested agent within the past 180 days or is at risk if therapy is changed, per initial criteria section.

Approval duration

12 months