Vosevi (sofosbuvir, velpatasvir, and voxilaprevir) — United Healthcare

chronic hepatitis C genotype 1, 2, 3, 4, 5 or 6 infection in patients who are treatment-experienced with an NS5A inhibitor-based regimen who are without cirrhosis or have compensated cirrhosis

Initial criteria

Diagnosis of chronic hepatitis C genotype 1, 2, 3, 4, 5 or 6 infection
Patient has prior treatment experience with an HCV NS5A inhibitor (e.g., Daklinza (daclatasvir), Epclusa (sofosbuvir/velpatasvir), Harvoni (ledipasvir/sofosbuvir), Viekira (dasabuvir/ombitasvir/paritaprevir/ritonavir), Zepatier (elbasvir/grazoprevir))
Patient is without cirrhosis OR has compensated cirrhosis (Child-Pugh A)
Patient is not receiving Vosevi in combination with another HCV direct acting antiviral agent (e.g., Epclusa, Harvoni, Mavyret, Sovaldi, Zepatier)
Physician/provider asserts patient demonstrates treatment readiness, including the ability to adhere to the treatment regimen

Approval duration

12 weeks