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Xyrem — Cigna

Cataplexy treatment in a patient with narcolepsy

Initial criteria

  • Patient age ≥ 7 years
  • Patient has been evaluated using polysomnography and a multiple sleep latency test
  • Diagnosis of narcolepsy has been confirmed, according to the prescriber
  • The medication has been prescribed by a sleep specialist physician or a neurologist
  • Patient has tried dextroamphetamine OR has a contraindication or intolerance to dextroamphetamine according to the prescriber

Approval duration

1 year