Epidiolex — Cigna

Initial criteria

• Patient is age ≥ 1 year; AND
• Patient meets ONE of the following (a or b): a) Patient has tried or is concomitantly receiving at least two other antiseizure medications; OR b) Patient has tried or is concomitantly receiving one of Fintepla, Diacomit, or clobazam; AND
• The medication is prescribed by or in consultation with a neurologist

Reauthorization criteria

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

Approval duration

1 year