Mavyret — Medical Mutual
Chronic Hepatitis C Virus (HCV), Genotype 2, 4, 5, or 6, Treatment-Experienced
Initial criteria
- Patient age ≥ 3 years
- Prescribed by or in consultation with a gastroenterologist, hepatologist, infectious diseases physician, or a liver transplant physician
- One of the following:
- No cirrhosis and relapse/partial/null with PegIFN/IFN + ribavirin or Sovaldi ± ribavirin. Approval: 8 weeks
- Compensated cirrhosis and relapse/partial/null with PegIFN/IFN + ribavirin or Sovaldi ± ribavirin. Approval: 12 weeks
Approval duration
8-12 weeks