Harvoni — Medica

Initial criteria

• age ≥ 18 years
• Patient is a kidney transplant recipient with HCV
• Medication is prescribed by or in consultation with a gastroenterologist, hepatologist, infectious diseases physician, nephrologist, liver transplant physician, or renal transplant physician affiliated with a transplant center

Reauthorization criteria

• Patient has been started on ledipasvir/sofosbuvir and is approved for an indication or condition addressed as an approval in the Recommended Authorization Criteria section
• Approve for the remaining duration required to complete the prescribed course of therapy

Approval duration

duration required to complete course of therapy