Lyrica — CareFirst (Caremark)
Adjunctive therapy for partial-onset (focal-onset) seizures in patients age ≥3 years
Preferred products
- gabapentin immediate-release
Initial criteria
- Request is for Lyrica (pregabalin immediate-release)
- If the request is for Lyrica oral solution, patient meets one of: (a) difficulty swallowing oral solids OR (b) requires a dose unobtainable using capsules
- Patient has experienced inadequate response, intolerance, or contraindication to gabapentin immediate-release
Reauthorization criteria
- Same criteria as initial authorization plus positive clinical response
Approval duration
12 months