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Nuedexta — CareFirst (Caremark)

pseudobulbar affect (PBA)

Initial criteria

  • Patient has a diagnosis of pseudobulbar affect (PBA).

Reauthorization criteria

  • Patient has a diagnosis of pseudobulbar affect (PBA).
  • Patient has achieved or maintained a decrease in PBA episodes since starting the requested drug.

Approval duration

Initial therapy: 4 months; Continuation of therapy: 36 months (policy 870-A) or 12 months (policy 599-A)