Adcirca — Cigna
Pulmonary Arterial Hypertension (PAH) [World Health Organization (WHO) Group 1]
Initial criteria
- Patient has had a right heart catheterization [documentation required]
- Results of the right heart catheterization confirm the diagnosis of WHO Group 1 PAH
- Medication is prescribed by or in consultation with a cardiologist or a pulmonologist
Reauthorization criteria
- Patient has had a right heart catheterization prior to starting therapy with a medication for WHO Group 1 PAH
- Results of the right heart catheterization confirm the diagnosis of WHO Group 1 PAH
- Medication is prescribed by or in consultation with a cardiologist or a pulmonologist
Approval duration
1 year