Corlanor — United Healthcare
stable, symptomatic chronic heart failure with left ventricular ejection fraction < 35%
Preferred products
- carvedilol
- metoprolol succinate
- bisoprolol
- Jardiance
- Farxiga
- captopril
- enalapril
- candesartan
- valsartan
- Entresto
- eplerenone
- spironolactone
Initial criteria
- Criterion A.a: All of the following:
- (1) Worsening heart failure in a diagnosis of stable, symptomatic chronic (e.g. NYHA class II, III or IV) heart failure
- AND (2) Left ventricular ejection fraction (EF) < 35%
- AND (3) Patient is in sinus rhythm
- AND (4) Resting heart rate > 70 beats per minute
- AND (5) One of the following:
- i. Patient is on a stabilized dose and receiving concomitant therapy with a maximally tolerated beta-blocker (e.g., carvedilol, metoprolol succinate, bisoprolol)
- OR ii. Contraindication or intolerance to beta-blocker therapy
- AND (6) One of the following:
- i. Patient is on a stabilized dose and receiving concomitant therapy with Jardiance or Farxiga (includes combination products containing empagliflozin and dapagliflozin)
- OR ii. Contraindication or intolerance to SGLT2 inhibitor therapy
- AND (7) One of the following:
- i. Patient is on a stabilized dose and receiving concomitant therapy with one of the following:
- - ACE inhibitor (e.g., captopril, enalapril)
- - ARB (e.g., candesartan, valsartan)
- - ARNI (e.g., Entresto)
- OR ii. Contraindication or intolerance to ACE inhibitors, ARBs, and ARNIs
- AND (8) One of the following:
- i. Patient is on a stabilized dose and receiving concomitant therapy with a maximally tolerated aldosterone antagonist (e.g., eplerenone, spironolactone)
- OR ii. Contraindication or intolerance to aldosterone antagonist therapy
- AND (9) Prescribed by or in consultation with a cardiologist
- OR Criterion A.b: All of the following:
- (1) Diagnosis of stable symptomatic heart failure due to dilated cardiomyopathy (DCM)
- AND (2) Patient is in sinus rhythm
- AND (3) Patient has an elevated heart rate
- AND (4) Prescribed by or in consultation with a cardiologist
- OR Criterion A.c: All of the following:
- (1) Diagnosis of inappropriate sinus tachycardia (IST)
- AND (2) Patient is in sinus rhythm
- AND (3) One of the following:
- i. Tried and failed or had an inadequate response to a beta-blocker (e.g., carvedilol, metoprolol succinate, bisoprolol)
- OR ii. Contraindication or intolerance to beta-blocker therapy
- AND (4) Prescribed by or in consultation with a cardiologist
- OR Criterion A.d: Patient is currently established on Corlanor therapy
Reauthorization criteria
- Documentation of positive clinical response to Corlanor therapy
Approval duration
12 months