Juxtapid (lomitapide) — United Healthcare

Initial criteria

• Diagnosis of homozygous familial hypercholesterolemia
• Patient is on a low-fat diet
• Patient is receiving other lipid-lowering therapy (e.g., statin, LDL apheresis)

Reauthorization criteria

• Patient is on a low-fat diet
• Patient is receiving other lipid-lowering therapy (e.g., statin, LDL apheresis)
• Documentation of positive clinical response to Juxtapid therapy

Approval duration

12 months