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Qfitlia (fitusiran)United Healthcare

Hemophilia A

Initial criteria

  • Diagnosis of hemophilia A AND prescribed for the prevention of bleeding episodes (routine prophylaxis)
  • Diagnosis of hemophilia B AND prescribed for the prevention of bleeding episodes (routine prophylaxis)

Reauthorization criteria

  • Documentation of positive clinical response to Qfitlia therapy

Approval duration

12 months