Banzel (rufinamide tablets and oral suspension – Eisai, generic) — Cigna

Initial criteria

• Patient age ≥ 1 year; AND
• Patient has tried and/or is concomitantly receiving at least two other antiseizure medications; AND
• The medication is prescribed by or in consultation with a neurologist.

Reauthorization criteria

• Patient is currently receiving rufinamide; AND
• Patient is responding to therapy (e.g., reduced seizure severity, frequency, and/or duration) as determined by the prescriber.

Approval duration

1 year