Valganciclovir (Valcyte) therapy for CMV
Criteria for medical necessity, prior authorization, and approval durations for oral valganciclovir (Valcyte) for CMV treatment and prophylaxis in transplant recipients and select HIV-associated CMV diseases affecting Centene lines of business.
For CMV retinitis, approval duration changed from 4 months to 3 months per CDC guidance.
For off-label post-transplant CMV infection, Valcyte must not be prescribed concurrently with Livtencity.
Added requirement in initial and continuation requests that member must use generic valganciclovir unless contraindicated.
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