Zavesca (miglustat capsules - Actelion, generic) — Cigna
Niemann-Pick disease type C (NPC)
Initial criteria
- Patient is age ≥ 2 years; AND
- Diagnosis is established by a molecular genetic test showing biallelic pathogenic variants in either the NPC1 or NPC2 gene; AND
- Medication is prescribed by or in consultation with a geneticist, endocrinologist, metabolic disorder subspecialist, or a physician who specializes in the treatment of NPC or related disorders.
Approval duration
1 year