fenfluramine — CareFirst (Caremark)
seizures associated with Dravet syndrome in patients age ≥ 2 years
Initial criteria
- Treatment of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome
- Member age ≥ 2 years
- Member is not concurrently using phentermine
Reauthorization criteria
- Member age ≥ 2 years
- Member has achieved or maintained a positive clinical response (e.g., decrease in seizure frequency)
- Continued request is for an indication listed in the coverage criteria
Approval duration
12 months