finerenone — CareFirst (Caremark)
Heart failure with left ventricular ejection fraction (LVEF) ≥ 40%
Initial criteria
- For CKD associated with T2DM: Patient has a diagnosis of chronic kidney disease associated with type 2 diabetes AND ONE of the following:
- • Patient is currently receiving a maximally tolerated dose of an angiotensin-converting enzyme inhibitor (ACEi) OR angiotensin receptor blocker (ARB).
- • Patient has experienced an intolerance to an ACEi or ARB.
- • Patient has a contraindication that would prohibit a trial of an ACEi or ARB.
- For heart failure with LVEF ≥ 40%: Requested drug is being prescribed to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits AND the patient has a diagnosis of heart failure with left ventricular ejection fraction (LVEF) ≥ 40%.
Approval duration
12 months