Lyrica (pregabalin immediate-release) — CareFirst (Caremark)
Adjunctive therapy for the treatment of partial-onset (focal-onset) seizures in a patient age ≥3 years
Preferred products
- gabapentin immediate-release
Initial criteria
- The request is for Lyrica (pregabalin immediate-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 experienced an inadequate treatment response, intolerance, or has a contraindication to gabapentin immediate-release.
Reauthorization criteria
- The request is for Lyrica (pregabalin immediate-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