More topics

Limited coverage drugs – vericiguat

Last updated on October 15, 2024

 

Return to Special Authority drug list

Generic name

vericiguat

Strength & form

2.5 mg, 5 mg, and 10 mg tablet

Special Authority criteria

Approval period

Initial

For the treatment of symptomatic chronic heart failure (HF) in adult patients 18 years of age and older with reduced ejection fraction who are stabilized after a recent decompensation event if ALL the following clinical criteria are met:

  • Left ventricular ejection fraction (LVEF) < 45% AND New York Heart Association (NYHA) Class II to IV

AND

  • The patient had a recent HF decompensation event requiring hospitalization and/or intravenous (IV) diuretic therapy1

AND

  • The patient will use vericiguat as an adjunct to standard of care2 therapy, which includes the following:
    • An angiotensim-coverting enzyme inhibitor (ACEI) OR angiotensin receptor blocker (ARB) OR angiotensin receptor/neprilysin inhibitor (ARNI),
      ​AND
    • A beta-blocker (BB),
      AND
    • A mineralocorticoid receptor antagonist (MRA),
      AND
    • A sodium-glucose cotransporter-2 inhibitor (SGLT2i)

Indefinite

 

Practitioner exemptions

  • None

Special notes

  • 1HF decompensation event requiring hospitalization within the 6 months prior to this request or patient received IV diuretic treatment for HF (without hospitalization) within 3 months prior to this request
  • 2Standard of care for HF is defined as: ACEI/ARB/ARNI and BB and MRA and SGLT2i, unless contraindicated or not tolerated
  • PharmaCare coverage is limited to maximum of 10 mg of vericiguat daily

Special Authority requests