Tryvio (aprocitentan) — United Healthcare

resistant hypertension

Initial criteria

Diagnosis of resistant hypertension
Systolic blood pressure ≥ 130 mm Hg on two consecutive measurements despite maximally tolerated antihypertensive treatment OR Diastolic blood pressure ≥ 80 mm Hg on two consecutive measurements despite maximally tolerated antihypertensive treatment
Patient has been previously treated with all of the following antihypertensive classes for an adequate duration (minimum 4 weeks each) at a maximally tolerated dose: 1) Maximally tolerated blocker of the renin-angiotensin system [ACE inhibitor (e.g., enalapril, lisinopril) or ARB (e.g., candesartan, valsartan)] 2) Maximally tolerated calcium channel blocker (e.g., amlodipine, diltiazem, verapamil) 3) Maximally tolerated diuretics (e.g., hydrochlorothiazide) 4) Maximally tolerated mineralocorticoid receptor antagonist (e.g., spironolactone, eplerenone)
Provider attests other causes of hypertension have been excluded (e.g., secondary causes, white coat effect, medication nonadherence)
Used as an adjunct to lifestyle modification (e.g., dietary or caloric restriction, exercise, behavioral support, community-based program)
Tryvio will be used in combination with at least 3 antihypertensive medications from different classes at maximally tolerated doses
Prescribed by or in consultation with a specialist experienced in the treatment of resistant hypertension (e.g., cardiologist, nephrologist)

Documentation the patient is receiving clinical benefit to Tryvio therapy
Tryvio will be used in combination with at least 3 antihypertensive medications from different classes at maximally tolerated doses

12 months