Lyrica (pregabalin) — CareFirst (Caremark)
Adjunctive therapy for the treatment of partial-onset (focal-onset) seizures in a patient 1 month to up to 3 years of age
Preferred products
- gabapentin immediate-release
Initial criteria
- The request is for Lyrica (pregabalin immediate-release)
- The requested drug is being prescribed for ONE of the above indications
- If the request is for Lyrica oral solution, the patient has difficulty swallowing oral solid dosage forms OR requires a dose not obtainable using capsules
Reauthorization criteria
- The request is for Lyrica (pregabalin immediate-release)
- The requested drug is being prescribed for one of the same indications
- If the request is for Lyrica oral solution, patient has difficulty swallowing oral solid dosage forms OR requires a dose not obtainable using capsules
- The patient has achieved or maintained a positive clinical response to the requested drug
Approval duration
12 months