Inpefa Prior Authorization Policy
Cigna prior authorization policy for coverage and medical necessity of Inpefa (sotagliflozin) for adults, covering FDA-approved heart failure and specific type 2 diabetes indications and noting investigational uses.
No material clinical or coverage changes in this revision.
Coverage Criteria for Inpefa (sotagliflozin)
FDA-Approved Indications
Covered when ALL of the following are met for each indication
Review under Heart Failure criteria
Patients with heart failure should be reviewed under Heart Failure criteria
Use of Inpefa (sotagliflozin) for Type 1 diabetes is considered experimental, investigational, or unproven and is excluded from coverage under this policy. Inpefa is not approved for glycemic control; requests for this indication may be denied as unproven.
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