Firdapse — Cigna
Lambert-Eaton Myasthenic Syndrome (LEMS)
Initial criteria
- Patient is age ≥ 6 years; AND
- According to the prescriber, patient has confirmed LEMS based on at least ONE of the following (a or b): a) Electrodiagnostic study (e.g., repetitive nerve stimulation); OR b) Anti-P/Q-type voltage-gated calcium channels antibody testing; AND
- Patient does not have a history of seizures; AND
- The medication is being prescribed by or in consultation with a neurologist or a neuromuscular specialist
Reauthorization criteria
- According to the prescriber, the patient is continuing to derive benefit from amifampridine (e.g., improved muscle strength and improvements in mobility)
Approval duration
initial 3 months; reauth 1 year