Corlanor — Medical Mutual

Initial criteria

• Patient has tried or is currently receiving one beta blocker for inappropriate sinus tachycardia OR patient has a contraindication to use of beta blocker therapy (e.g., bronchospastic disease such as COPD or asthma, severe hypotension, bradycardia)
• Medication is prescribed by or in consultation with a cardiologist

Reauthorization criteria

• Response to therapy is required for continuation

Approval duration

6 months initial, 1 year reauth