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FirdapseCareFirst (Caremark)

Lambert-Eaton myasthenic syndrome (LEMS)

Initial criteria

  • Diagnosis is confirmed by either of the following: electromyography (EMG) showing compound muscle action potential (CMAP) increased at least 2-fold after maximum voluntary contraction of the tested muscle OR a positive anti-P/Q type voltage-gated calcium channel antibody test
  • Member has proximal muscle weakness
  • For treatment-naïve members, the Quantitative Myasthenia Gravis (QMG) score is at least 5
  • Coverage will not be provided for members with a history of seizures

Reauthorization criteria

  • Member is responding to therapy (i.e., there is stability or improvement in symptoms relative to the natural course of LEMS)

Approval duration

Initial: 6 months; Reauthorization: 12 months