WHA

Verquvo (vericiguat)

Indications for Prior Authorization

Verquvo (vericiguat)
  • For diagnosis of Chronic Heart Failure
    Indicated to reduce the risk of cardiovascular death and heart failure (HF) hospitalization following a hospitalization for heart failure or need for outpatient IV diuretics, in adults with symptomatic chronic HF and ejection fraction less than 45%.

Criteria

Verquvo

Prior Authorization (Initial Authorization)

Length of Approval: 12 Month(s)

  • Diagnosis of chronic heart failure
    • AND
  • Patient has an ejection fraction less than 45 percent
    • AND
  • Patient has New York Heart Association (NYHA) Class II, III, or IV symptoms
    • AND
  • One of the following:
    • Patient was hospitalized for heart failure within the last 6 months
      • OR
    • Patient used outpatient intravenous diuretics (e.g., bumetanide, furosemide) for heart failure within the last 3 months
    AND
  • Trial and failure, contraindication, or intolerance to all of the following at a maximally tolerated dose: [1-4]
    • One of the following:
      • Angiotensin converting enzyme (ACE) inhibitor (e.g., captopril, enalapril)
      • Angiotensin II receptor blocker (ARB) (e.g., candesartan, valsartan)
      • Angiotensin receptor-neprilysin inhibitor (ARNI) [e.g., Entresto (sacubitril and valsartan)]
      AND
    • One of the following: [A, 4]
      • bisoprolol
      • carvedilol
      • metoprolol succinate extended-release
      AND
    • Sodium-glucose co-transporter 2 (SGLT2) inhibitor [e.g., Jardiance (empagliflozin), Farxiga (dapagliflozin), Xigduo XR (dapagliflozin and metformn)]
      • AND
    • Mineralocorticoid receptor antagonist (MRA) [e.g., eplerenone, spironolactone]
    AND
  • Prescribed by or in consultation with a cardiologist
Verquvo

Prior Authorization (Reauthorization)

Length of Approval: 12 Month(s)

  • Patient demonstrates positive clinical response to therapy

  • Guideline ID
    GL-143367

  • Formulary
    premium

  • Effective date
    May 1, 2024

  • P&T approval date

P & T Revisions

2024-03-07, 2023-10-17, 2023-03-16, 2022-08-18, 2022-03-03, 2021-03-03

  1. Verquvo Prescribing Information. Merck & Co., Inc. Whitehouse Station, NJ. July 2023.
  2. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013 Oct 15;128(16):e240-327.
  3. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Card Fail. 2017 Aug;23(8):628-651.
  4. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Journal of Cardiac Failure. Published online April 2022.
  1. Per 2022 AHA/ACC/HFSA guideline for the management of Heart Failure, three beta blockers have been shown to be effective in reducing the risk of death in patients with HFrEF: bisoprolol, metoprolol succinate, and carvedilol. [4]
  • 2024-03-07: 2024 Annual Review. No criteria changes. Background updates.
  • 2023-10-17: Program update to standard reauthorization language. No changes to clinical intent.
  • 2023-03-16: Annual review, no changes to criteria
  • 2022-08-18: Addition of SGLT2 inhibitor and MRA as step requirements
  • 2022-03-03: Annual review: Background updates.
  • 2021-03-03: New program