ADEMPAS (riociguat)

SELF ADMINISTRATION - ORAL 

Indications for Prior Authorization:

  • Indicated in adults for the treatment of pulmonary arterial hypertension (PAH) [WHO group 1] to improve exercise capacity, WHO functional class and to delay clinical worsening. 
  • Also indicated in the adults for the treatment of persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) [WHO group 4] after surgical treatment, or inoperable CTEPH, to improve exercise capacity and WHO functional class. 

Patients must meet the following criteria for the indication(s) above:

  • Patient is 18 years of age or older, AND
  • Diagnosis of PAH or CTEPH confirmed by chart note documentation, AND
  • Prescribed by or in consultation with a cardiologist or pulmonologist, AND
  • Patient has had a right heart catheterization confirmed by chart note documentation, OR
  • Results of the right heart catheterization confirms diagnosis of WHO group 1 PAH
  • For CTEPH: disease is persistent/inoperable

Dosing:

  • 1 mg by mouth 3 times daily
  • For oral use only 
  • Dose does not exceed 7.5 mg per day

Approval: 

  • 1 year

Last review date: February 24, 2020

Friday, July 19 Breaking News: A widespread computer software outage is impacting systems across the globe. Health care services in Northern California are reporting some disruption. WHA encourages members to call ahead to your provider if you have an appointment scheduled for today or this weekend.