Vosevi — Cigna
Genotype 1, 2, 3, 4, 5, or 6 chronic Hepatitis C Virus – new start
Initial criteria
- Approve for the duration specified in the standard Hepatitis C – Vosevi PA Policy criteria if the patient has met the standard Hepatitis C – Vosevi PA Policy criteria.
Reauthorization criteria
- Refer to the standard Hepatitis C – Vosevi PA Policy criteria.
Approval duration
duration specified in standard Vosevi PA Policy