Pharmacy Prior Authorization Criteria

Myqorzo (aficamten)

Indications for Prior Authorization

Myqorzo (aficamten)

• For diagnosis of Obstructive hypertrophic cardiomyopathy (HCM)
  Indicated for the treatment of adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) to improve functional capacity and symptoms.

Criteria

Myqorzo

Prior Authorization (Initial Authorization)

Length of Approval: 6 Month(s)

• Diagnosis of obstructive hypertrophic cardiomyopathy (HCM)
AND
• Patient has New York Heart Association (NYHA) Class II or III symptoms (e.g., shortness of breath, chest pain)
AND
• Both of the following were measured prior to Myqorzo therapy:
• Patient had a left ventricular ejection fraction of greater than or equal to 55%
AND
• Patient had a valsalva left ventricular outflow tract (LVOT) peak gradient greater than or equal to 50 mmHg at rest or with provocation
AND
• Trial and inadequate response, contraindication, or intolerance to one of the following at a maximally tolerated dose: [C, 2]
• non-vasodilating beta blocker (e.g., bisoprolol, propranolol)
• calcium channel blocker (e.g., verapamil, diltiazem)
AND
• Requested drug will not be used in combination with another cardiac myosin inhibitor (e.g., Camzyos)
AND
• Prescribed by or in consultation with a cardiologist

Myqorzo

Prior Authorization (Reauthorization)

Length of Approval: 12 Month(s)

• Patient demonstrates positive clinical response to therapy (e.g., improved symptom relief)
AND
• Patient has a left ventricular ejection fraction of greater than or equal to 50% [A, B, 1]
AND
• Requested drug will not be used in combination with another cardiac myosin inhibitor (e.g., Camzyos)
AND
• Prescribed by or in consultation with a cardiologist

P & T Revisions

2026-03-04

References

1. Myqorzo Prescribing Information. Cytokinetics Incorporate. South San Francisco, CA. December 2025.
2. Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(23).

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End Notes

1. Patients may develop heart failure while taking MYQORZO. Regular LVEF and Valsalva left ventricular outflow tract gradient (LVOT-G) assessment is needed for titration to achieve an appropriate target Valsalva LVOT-G, while maintaining LVEF ≥50% and avoiding heart failure symptoms. [1]
2. Initiation or up-titration of MYQORZO in patients with LVEF <55% is not recommended. [1]
3. In general, nonvasodilating beta blockers are considered first-line therapy. The calcium channel blockers—verapamil or diltiazem—are reasonable alternatives to beta-blocker therapy. For patients who do not respond to trials of ≥1 of these drugs, advanced therapies with disopyramide, mavacamten (a cardiac myosin inhibitor), or septal reduction are often the next step. [2]

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Revision History

• 2026-03-04: New Program

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