Verquvo — Medical Mutual

Cardiovascular death and heart failure hospitalization risk reduction in symptomatic chronic HF with LVEF <45%

Initial criteria

Patient age ≥ 18 years
Diagnosis of symptomatic chronic HF, NYHA class II-IV
Ejection fraction (LVEF) < 45%
Patient is not pregnant
Recent hospitalization for HF (within 6 months of therapy initiation) OR recent need for outpatient IV diuretics (within 3 months of therapy initiation)
Verquvo is prescribed by or in consultation with a cardiologist
Dose of Verquvo will not exceed 10 mg/day
Patient had prior therapy trials with an ACEI/ARB and/or beta-blocker and/or mineralocorticoid receptor antagonist (MRA)
Patient will continue to receive concomitant therapy with at least THREE (3) other agents for HF, each from a separate pharmacotherapeutic class (ACEI or ARB; AND/OR beta-blocker; AND/OR MRA; AND/OR diuretic; AND/OR SGLT-2 inhibitor; AND/OR Entresto; AND/OR Corlanor; AND/OR hydralazine and isosorbide dinitrate)

Patient age ≥ 18 years
Diagnosis of chronic HF NYHA class II-IV with ejection fraction < 45%
Verquvo is prescribed by or in consultation with a cardiologist
Dose of Verquvo will not exceed 10 mg/day
Patient is not pregnant
Prescriber determines that patient has experienced clinical benefit while taking Verquvo (e.g. decreased hospitalizations, improved symptoms, improved quality of life, reduction in need of IV diuretics)
Patient will continue to receive concomitant therapy with at least THREE (3) other agents for HF, each from a separate pharmacotherapeutic class (ACEI or ARB; AND/OR beta-blocker; AND/OR MRA; AND/OR diuretic; AND/OR SGLT-2 inhibitor; AND/OR Entresto; AND/OR Corlanor; AND/OR hydralazine and isosorbide dinitrate)

1 year initial, 1 year reauth