Fintepla (fenfluramine oral solution – Zogenix) — Cigna

Initial criteria

• Patient is age ≥ 2 years; 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 clobazam, Epidiolex, or Diacomit; AND
• Fintepla is prescribed by or in consultation with a neurologist

Reauthorization criteria

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

Approval duration

1 year