Vosevi — Medical Mutual
Chronic Hepatitis C Virus (HCV) Genotype 1a or 3
Initial criteria
- Patient age ≥ 18 years; AND
- Patient does not have cirrhosis OR the patient has compensated cirrhosis (Child-Pugh A); AND
- Patient meets ONE of the following conditions (i or ii):
- i. Patient had a prior null response, prior partial response, or had relapse after prior treatment with an HCV direct-acting antiviral regimen containing an NS5A inhibitor; OR
- ii. Patient had a prior null response, prior partial response, or had relapse after prior treatment with an HCV direct-acting antiviral regimen containing Sovaldi (sofosbuvir tablets/oral pellets) + a non-NS5A inhibitor; AND
- This medication is prescribed by or in consultation with a gastroenterologist, hepatologist, infectious diseases physician, or a liver transplant physician
Approval duration
12 weeks