Uptravi
Drug - Uptravi® (sekexipag) [Actelion Pharmaceuticals US, Inc.]
August 2017
Therapeutic area - Pulmonary arterial hypertension
Approval criteria
- Patient must be 18 years of age or older AND
- Uptravi is prescribed by, or in consultation with, a cardiologist or pulmonologist AND
- Patient must have a diagnosis of pulmonary arterial hypertension (PAH, WHO Group 1) AND
- Patient has WHO Functional Class II-III symptoms AND
- Patient is not smoking tobacco products AND
- Patient must have tried and failed a calcium channel blocker if they have a positive vasoreactivity test AND
- Patient must have tried and failed sildenafil (Revatio) or taladafil (Adcirca) AND
- Unless pregnant, patient must have tried and failed ambrisentan or bosentan
Quantity limits
- Tablets (all strengths): 68 tablets per 34 days
- Titration pack: 1 pack
Questions?
MHCP Provider Call Center 651-431-2700 or 800-366-5411