Skip to content
The Policy VaultThe Policy Vault

TadliqCigna

Pulmonary arterial hypertension (PAH) (WHO Group I)

Preferred products

  • generic tadalafil tablets (20 mg)
  • Alyq

Initial criteria

  • Patient meets the standard Pulmonary Arterial Hypertension – Phosphodiesterase Type 5 Inhibitors Prior Authorization Policy criteria
  • Patient meets ONE of the following: (i) Patient has tried Alyq or generic tadalafil 20 mg tablets; OR (ii) Patient cannot swallow or has difficulty swallowing Alyq or generic tadalafil 20 mg tablets; OR (iii) Patient requires administration of a dose that cannot be obtained with generic tadalafil 20 mg tablets

Approval duration

1 year