Epidiolex — Cigna
Treatment-Refractory Seizures/Epilepsy [specific rare conditions] (CDKL5 deficiency disorder; Dup15q, Aicardi, or Doose syndromes; febrile infection‐related epilepsy syndromes; focal epilepsy; Sturge‐Weber syndrome; lissencephaly; cortical malformation/dysplasia; epilepsy with myoclonic absences)
Initial criteria
- Patient is ≥ 1 year of age; AND
- Patient has tried 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 Epidiolex; AND
- Patient is responding to therapy (e.g., reduced seizure severity, frequency, and/or duration) as determined by the prescriber
Approval duration
1 year