HHSC will update the clinical prior authorization criteria for Repatha on Dec. 6, 2021, to reflect the recent FDA-approved age expansion. Repatha is now indicated for the treatment of pediatric patients age 10 and older with heterozygous familial heprercholesterolemia (HeFH). Previously, this product was approved for patients age 13 and older with homozygous familial hypercholesterolemia (HoFH).
This clinical prior authorization is optional for managed care. The Clinical Prior Authorization Assistance Chart indicates which prior authorization each MCO uses. The chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.