Remodulin — Medical 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