Livtencity — Medical Mutual
Cytomegalovirus infection - treatment in post-transplant patients
Initial criteria
- Patient age ≥ 12 years
- Patient weight ≥ 35 kg
- Patient is post-transplant (includes post hematopoietic stem cell transplant or solid organ transplant)
- Patient has cytomegalovirus infection/disease that is refractory to treatment with at least one of the following: cidofovir, foscarnet, ganciclovir, or valganciclovir
- Livtencity is not prescribed in conjunction with ganciclovir or valganciclovir
- Prescribed by or in consultation with a hematologist, infectious diseases specialist, oncologist, or a physician affiliated with a transplant center
Approval duration
2 months (60 days)