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NexlizetCareFirst (Caremark)

Primary hyperlipidemia (including heterozygous familial hypercholesterolemia (HeFH))

Initial criteria

  • Patient age ≥ 18 years
  • Requested drug is being prescribed as an adjunct to diet
  • Patient meets ONE of the following: (a) requested drug will be used in combination with other low-density lipoprotein cholesterol (LDL-C) lowering therapies, OR (b) concomitant use of the requested drug with other LDL-C lowering therapies is NOT possible

Reauthorization criteria

  • Requested drug is being prescribed as an adjunct to diet
  • Patient has achieved or maintained a reduction in low-density lipoprotein cholesterol (LDL-C) from baseline

Approval duration

36 months