Harvoni (ledipasvir/sofosbuvir) — United Healthcare
Chronic hepatitis C genotype 1 infection, treatment-naïve with compensated cirrhosis
Initial criteria
- Diagnosis of chronic hepatitis C genotype 1 infection
- Patient has compensated cirrhosis (Child-Pugh A)
- Patient is treatment naïve (no failure with peginterferon +/- ribavirin regimen with/without HCV protease inhibitor or Sovaldi)
- Patient is not receiving Harvoni in combination with another HCV direct acting antiviral agent
Approval duration
12 weeks