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AdempasMedical Mutual

Pulmonary Arterial Hypertension (PAH) [WHO Group 1]

Initial criteria

  • Patient has a diagnosis of WHO Group 1 pulmonary arterial hypertension (PAH); AND
  • Patient has had a right heart catheterization; AND
  • Results of the right heart catheterization confirm the diagnosis of WHO Group 1 PAH; AND
  • Medication is prescribed by or in consultation with a cardiologist or a pulmonologist

Reauthorization criteria

  • Patient has a diagnosis of WHO Group 1 PAH; AND
  • Patient has had a right heart catheterization; AND
  • Results of the right heart catheterization confirm the diagnosis of WHO Group 1 PAH; AND
  • Medication is prescribed by or in consultation with a cardiologist or a pulmonologist

Approval duration

1 year