Lyrica (pregabalin) — CareFirst (Caremark)

Preferred products

• gabapentin immediate-release

Initial criteria

• The request is for one of the listed drugs
• If Lyrica oral solution—patient has difficulty swallowing oral solids OR requires a dose not obtainable via capsules
• Patient experienced inadequate response, intolerance, or contraindication to gabapentin immediate-release

Reauthorization criteria

• Request is for one of the listed drugs
• If Lyrica oral solution—patient has difficulty swallowing oral solids OR requires a dose not obtainable via capsules
• Patient has achieved or maintained a positive clinical response to the requested drug

Approval duration

12 months