Hetlioz (tasimelteon capsules - Vanda) — Cigna

Non-24-Hour Sleep-Wake Disorder (Non-24)

Initial criteria

Patient has a diagnosis of Non-24-Hour Sleep-Wake Disorder (Non-24).
Diagnosis is confirmed in a totally blind individual, AND patient reports sleep-wake complaints associated with the disorder.
Patient is age ≥ 18 years.
Patient has had an inadequate response, intolerance, or contraindication to ramelteon (Rozerem, generic).
Patient is not using ramelteon concomitantly with tasimelteon capsules.
The medication is prescribed by or in consultation with a physician who specializes in the treatment of sleep disorders.

Patient continues to meet the initial approval criteria.
Patient has demonstrated adequate clinical response to tasimelteon capsule therapy (e.g., entrainment, clinically meaningful or significant increases in nighttime sleep, clinically meaningful or significant decreases in daytime sleep).
Medication remains prescribed by or in consultation with a physician who specializes in the treatment of sleep disorders.

12 months