Zepatier (elbasvir/grazoprevir) — Blue Cross Blue Shield of Kansas
Hepatitis C genotype 1 or 4
Preferred products
- Epclusa (sofosbuvir/velpatasvir)
- Harvoni (ledipasvir/sofosbuvir)
- Ledipasvir/Sofosbuvir
- Sofosbuvir/Velpatasvir
- Mavyret (glecaprevir/pibrentasvir)
- Vosevi (sofosbuvir/velpatasvir/voxilaprevir)
Initial criteria
- The patient has a diagnosis of hepatitis C genotype 1 or 4 AND
- BOTH of the following must be met (criteria continue beyond text shown)