Lunesta — CareFirst (Caremark)

Initial criteria

• Authorization may be granted when the requested drug is being prescribed for insomnia when potential factors contributing to sleep disturbances have been addressed or are currently being addressed (e.g., inappropriate sleep hygiene and sleep environment issues) as well as treatable medical/psychiatric disorders that are co-morbid with insomnia.

Reauthorization criteria

• Authorization may be granted when the requested drug is being prescribed for insomnia and ALL of the following criteria are met: The patient has achieved or maintained a positive response to treatment from baseline; The patient’s need for continued therapy has been assessed; Potential factors contributing to sleep disturbances continue to be addressed (e.g., inappropriate sleep hygiene, sleep environment issues, treatable medical/psychiatric comorbid disorders).

Approval duration

Initial therapy: 6 months; Continuation: 12 months