Nayzilam (midazolam nasal spray) — CareFirst (Caremark)
Acute treatment of intermittent, stereotypic episodes of frequent seizure activity (i.e., seizure clusters, acute repetitive seizures) that are distinct from the patient’s usual seizure pattern in patients with epilepsy
Initial criteria
- The requested drug is being prescribed for the acute treatment of intermittent, stereotypic episodes of frequent seizure activity (i.e., seizure clusters, acute repetitive seizures) that are distinct from the patient’s usual seizure pattern in a patient with epilepsy
- The patient is age ≥ 12 years
Approval duration
12 months