Tyvaso — United Healthcare
Pulmonary arterial hypertension (WHO Group 1)
Initial criteria
- EITHER: ALL of the following: Pulmonary arterial hypertension is symptomatic AND Diagnosis confirmed by right heart catheterization AND Prescribed by or in consultation with cardiologist, pulmonologist, or rheumatologist
- OR: BOTH of the following: Patient currently on any therapy for pulmonary arterial hypertension AND Prescribed by or in consultation with cardiologist, pulmonologist, or rheumatologist
Reauthorization criteria
- Documentation that patient is receiving clinical benefit to therapy
Approval duration
12 months