Effective immediately, Harvard Pilgrim is covering the medication Corlanor with prior authorization. In April, the U.S. Food and Drug Administration (FDA) approved Corlanor (ivabradine) — which is a hyperpolarization-activated cyclic nucleotide-gated channel blocker — for use in reducing the risk of hospitalization for worsening heart failure in select patients.
Corlanor will be covered on the Premium formularies only, at the highest tier (i.e. Tier 3 on the 3-Tier and Tier 4 on the 4-Tier). Harvard Pilgrim is requiring prior authorization to ensure the safe and appropriate use of Corlanor. Harvard Pilgrim's Corlanor Clinical Coverage Criteria detail the requirements that must be met in order to obtain prior authorization, including:
- Patient has a diagnosis of symptomatic chronic heart failure (NYHA class II-IV) with left ventricular ejection fraction (EF) < 35%
- Corlanor is prescribed by a cardiologist or specialist in cardiac care
- Patient has a resting heart beat > 70 beats or more per minute
- Patient is on maximally tolerated doses of beta blockers (e.g., carvedilol, metoprolol succinate, bisoprolol) or has a contraindication to beta blockers
Approvals will be valid for 12 months. To request prior authorization, please complete the Corlanor Medication Request Form and fax it to MedImpact Healthcare Systems at 888-807-6643. For more information, please refer to the Pharmacy section of Harvard Pilgrim's provider website.