Harvoni (ledipasvir/sofosbuvir) — Blue Cross Blue Shield of Oklahoma
Hepatitis C genotype 1 or 4
Preferred products
- Epclusa (sofosbuvir/velpatasvir)
Initial criteria
- Diagnosis of hepatitis C genotype 1 or 4
- If genotype 1, prescriber must provide subtype
- If subtype 1a, prescriber must test patient for NS5A polymorphisms