Zepatier — Medica
genotype 1 chronic hepatitis C virus infection
Initial criteria
- Patient has genotype 1 or 4 chronic hepatitis C virus infection
- Patient meets criteria in the standard Hepatitis C – Zepatier PA Policy
Reauthorization criteria
- Refer to the standard Hepatitis C – Zepatier PA Policy criteria
Approval duration
as specified in the standard Hepatitis C – Zepatier PA Policy criteria