Product Details

Verquvo

Vericiguat
5 mg
Tablet


DIN/PIN/NPN

02537052

Manufacturer

Bayer Inc., Health Care Division

Formulary Listing Date

2024-09-27  

Unit Price

4.8300

Amount MOH Pays

4.8300

Coverage Status

Limited Use Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

C01DX22

Interchangeable Products

NO  

LU Clinical Criteria

LU Code Auth. Period Clinical Criteria
685 Indefinite

For the treatment of symptomatic chronic heart failure (HF) as an adjunct to standard-of-care therapy in adult patients with reduced ejection fraction who are stabilized after a recent HF decompensation event, if all the following conditions are met:

(a) Left ventricular ejection fraction (LVEF) less than 45%;

(b) New York Heart Association (NYHA) class II to IV symptoms;

(c) HF decompensation event requiring hospitalization within the previous 6 months and/or intravenous diuretic treatment for HF (without hospitalization) within the previous 3 months;

(d) Vericiquat is used in combination with standard-of-care* HF therapy; and

(e) Initiated under the supervision of a prescriber who is experienced in the management of HF.

* Standard-of-care HF therapy includes one medication from each of the following categories, unless there is a contraindication or intolerance:

(a) angiotensin receptor-neprilysin inhibitor (ARNI) or angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB);

(b) beta blocker;

(c) mineralocorticoid receptor antagonist (MRA); and

(d) sodium-glucose cotransporter-2 (SGLT2) inhibitor

 

EAP Criteria

NO

Product Monograph

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