Mavyret (glecaprevir/pibrentasvir) — United Healthcare
chronic hepatitis C genotype 1, 2, 3, 4, 5, or 6 infection
Initial criteria
- Diagnosis of chronic hepatitis C genotype 1, 2, 3, 4, 5 or 6 infection AND Patient is treatment-naïve AND One of the following: (Patient is without cirrhosis OR Patient has compensated cirrhosis (Child-Pugh A)) AND Patient is not receiving Mavyret in combination with another HCV direct acting antiviral agent
Approval duration
8 weeks