Onfi — Cigna
Dravet Syndrome
Initial criteria
- Patient age ≥ 2 years; AND
- Clobazam is prescribed by or in consultation with a neurologist
Reauthorization criteria
- Patient is currently receiving clobazam and is responding to therapy as determined by the prescriber (e.g., reduced seizure severity, frequency, and/or duration from baseline)
Approval duration
1 year