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The Policy VaultThe Policy Vault

Ledipasvir/Sofosbuvir — Blue Cross Blue Shield of Texas

hepatitis C genotype 1 or 4

Preferred products

  • Epclusa (sofosbuvir/velpatasvir)

Initial criteria

  • The patient has a diagnosis of hepatitis C genotype 1 or 4 AND
  • BOTH of the following: (A) If genotype 1, prescriber has provided patient’s subtype AND (B) If subtype 1a, prescriber has tested for NS5A polymorphisms