Health Net
Adcirca (tadalafil (pulm. hypertension))
Drugs for the Heart : Drugs for High Blood Pressure
  • Quantity Limit: New commercial members to be referred to AcariaHealth.
  • Prior Authorization: Pulmonary Arterial Hypertension:
    Duration: 1 plan year

  • Pulmonary Arterial Hypertension:
    Duration: 1 plan year
    Specialist Required: Yes

  • Step Therapy: Pulmonary Arterial Hypertension:
    ST Multiple Generics

  • 1. Diagnosis of pulmonary arterial hypertension (PAH) (WHO Group 1). Coverage is Not Authorized For: 1. Patients taking nitrates (e.g., Nitrodur, Nitrobid, Nitrostat, Isordil, Ismo). 2. Patients taking gunylate cyclase (GC) stimulators (e.g., Adempas); 3. Patients taking phosphodiesterase type 5 (PDE­5) inhibitors. Authorization Limit: Length of benefit.