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Winrevair — Point32Health

Pulmonary Arterial Hypertension (PAH) – WHO Group 1

Initial criteria

  • Documented diagnosis of pulmonary arterial hypertension (PAH) – World Health Organization (WHO) Group 1
  • Prescribed by or in consultation with a cardiologist or pulmonologist
  • Documentation diagnosis is confirmed by right heart catheterization with one (1) of the following parameters:
  • Mean pulmonary artery pressure (PAP) ≥ 25 mmHg at rest or ≥ 30 mmHg with exertion
  • Pulmonary capillary wedge pressure (PCWP) ≤ 15 mmHg
  • Pulmonary vascular resistance (PVR) > 3 Wood units
  • Documentation the patient is in Functional Class II or III
  • Documentation of one (1) of the following:
  • The patient is currently taking at least two other pulmonary arterial hypertension therapies from the following different pharmacologic categories: endothelin receptor antagonist, phosphodiesterase-5 inhibitor, soluble guanylate cyclase stimulator, and prostacylins
  • The patient is currently receiving at least one other pulmonary arterial hypertension therapies and is intolerant to combination therapy with an endothelin receptor antagonist, phosphodiesterase-5 inhibitor, soluble guanylate cyclase stimulator, or prostacylins