Multaq — United Healthcare

Initial criteria

• Diagnosis of a history of one of the following: (1) Paroxysmal atrial fibrillation (AF) (2) Persistent AF defined as AF less than 6 months duration
• AND Patient is in sinus rhythm OR Patient is planned to undergo cardioversion to sinus rhythm
• AND Patient has none of the following: (1) NYHA Class IV heart failure (2) Symptomatic heart failure with recent decompensation requiring hospitalization

Reauthorization criteria

• Continuation of current therapy

Approval duration

12 months