Lyrica CR (pregabalin extended-release) — CareFirst (Caremark)
Neuropathic pain associated with diabetic peripheral neuropathy
Preferred products
- gabapentin immediate-release
- duloxetine
- venlafaxine
- tricyclic antidepressant
Initial criteria
- If the request is for Lyrica (pregabalin immediate-release), and if oral solution is requested, the patient has difficulty swallowing oral solid dosage forms OR requires a dose that cannot be obtained using the commercially available capsules.
- The patient experienced an inadequate treatment response, intolerance, or has a contraindication to gabapentin immediate-release.
- If the request is for Lyrica CR, the patient experienced an inadequate treatment response, intolerance, or has a contraindication to TWO of the following: gabapentin immediate-release, pregabalin immediate-release, duloxetine, venlafaxine, or a tricyclic antidepressant.
Reauthorization criteria
- The request is for Lyrica (pregabalin immediate-release) or Lyrica CR (pregabalin extended-release).
- If the request is for Lyrica oral solution, the patient has difficulty swallowing oral solid dosage forms OR requires a dose that cannot be obtained using the commercially available capsules.
- The patient has achieved or maintained a positive clinical response to the requested drug.
Approval duration
12 months