Sovaldi — Cigna
Genotype 2 or 3 Chronic Hepatitis C Virus, Pediatric patients age ≥ 3 years and < 18 years
Preferred products
- Epclusa (brand)
Initial criteria
- For new start pediatric genotype 2 or 3 patients: Sovaldi is not approved; offer to review for Epclusa (brand only) using standard Hepatitis C – Epclusa PA Policy criteria
- For patients continuing therapy: refer to the standard Hepatitis C – Sovaldi PA Policy criteria
Approval duration
per respective Hepatitis C PA Policy