Limited Coverage Drugs – Sacubitril-Valsartan
Generic Name: |
sacubitril-valsartan |
|
---|---|---|
Strength: |
24 mg/26 mg, 49 mg/51 mg, 97 mg/103 mg |
|
Form: |
tablets |
Special Authority Criteria |
Approval Period |
---|---|
For the treatment of heart failure (HF) with reduced ejection fraction in patients with New York Heart Association (NYHA) class II or III HF if all of the following clinical criteria are met:
AND NYHA class II to III symptoms have persisted despite at least four weeks of treatment at the optimum stable doses of:
Notes:
|
Indefinite |
Practitioner Exemptions
- There are no practitioner exemptions.
Special Notes
- None