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RemodulinMedical Mutual

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) [WHO Group 4]

Initial criteria

  • Diagnosis of CTEPH (WHO Group 4); AND
  • Patient has been treated surgically OR CTEPH is inoperable; AND
  • Prescribed by or in consultation with a cardiologist or a pulmonologist

Reauthorization criteria

  • Patient is benefiting from the agent as determined by the prescribing physician (e.g., improving in functional class, quality of life, or hemodynamic or clinical parameters)

Approval duration

initial 6 months, reauth 6 months