Inbrija — CareFirst (Caremark)
Intermittent treatment of OFF episodes in patients with Parkinson’s disease treated with carbidopa/levodopa
Initial criteria
- Member experiences at least 2 hours per day of 'off' time
- Member is currently being treated with oral carbidopa/levodopa
- Attempts to manage 'off' episodes by adjusting the dosing or formulation of carbidopa/levodopa were ineffective
- Treatment with carbidopa/levodopa plus one of the following therapies was ineffective at managing 'off' episodes: Dopamine agonist (e.g., pramipexole, ropinirole) OR Monoamine oxidase B (MAO-B) inhibitor (e.g., selegiline, rasagiline) OR Catechol-O-methyltransferase (COMT) inhibitor (e.g., entacapone, tolcapone)
Reauthorization criteria
- Member is currently being treated with oral carbidopa/levodopa
- Member is experiencing improvement with the requested medication (e.g., reduction in daily 'off' time, improvement in motor function post-administration)
Approval duration
Initial: 6 months; Reauthorization: 12 months