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NexlizetCareFirst (Caremark)

Risk reduction of myocardial infarction and coronary revascularization

Initial criteria

  • Patient age ≥ 18 years
  • Patient has ANY of the following: established cardiovascular disease (CVD) OR a high risk for a CVD event but without established CVD
  • Patient meets ONE of the following: (a) patient experienced an intolerance to recommended statin therapy, OR (b) patient has a contraindication that would prohibit use of statin therapy

Reauthorization criteria

  • All patients (including new patients) requesting authorization for continuation of therapy must meet ALL requirements in the coverage criteria section

Approval duration

36 months