Epclusa (brand) — Medica
chronic hepatitis C virus (HCV) consistent with standard Hepatitis C – Epclusa PA Policy
Preferred products
- Epclusa (brand)
- Harvoni (brand)
- Vosevi
- Zepatier
Initial criteria
- Patient has met the standard Hepatitis C – Epclusa Prior Authorization Policy criteria.
Approval duration
as specified in the standard Hepatitis C – Epclusa PA Policy