Vyvanse — CareFirst (Caremark)
Moderate to severe binge-eating disorder (BED)
Initial criteria
- For ADHD or Attention Deficit Disorder (ADD):
- • Diagnosis appropriately documented (e.g., evaluated by complete clinical assessment, using DSM-5, standardized rating scales, interviews/questionnaires).
- • If patient age ≤ 5 years, patient continues to have ADHD/ADD symptoms despite participating in evidence-based behavioral therapy (e.g., parent training in behavior management, behavioral classroom interventions).
- For binge-eating disorder (BED): follow labeled indications (adult only).
Reauthorization criteria
- ADHD or ADD:
- • Patient achieved or maintained improvement in signs and symptoms of ADHD/ADD from baseline.
- • Patient’s need for continued therapy has been assessed within the previous year.