Covered Uses: | All FDA-approved indications not otherwise excluded from Part D. Patients currently on Remodulin for a Covered Use. |
Exclusion Criteria: | N/A |
Required Medical Information: | Pulmonary arterial hypertension PAH WHO Group 1, patients not currently on Remodulin or another agent indicated for WHO Group 1 PAH are required to have had a right-heart catheterization to confirm the diagnosis of PAH to ensure appropriate medical assessment. Pulmonary arterial hypertension (PAH) WHO Group1, patients currently on Remodulin or another agent indicated for WHO Group 1 may continue therapy without confirmation of a right-heart catheterization. |
Age Restrictions: | N/A |
Prescriber Restrictions: | PAH WHO Group 1, prescribed by or in consultation with a cardiologist or a pulmonologist. |
Coverage Duration: | Authorization will be for 12 months. |
Other Criteria: | N/A |