Nuplazid (pimavanserin) — Highmark
hallucinations and delusions associated with Parkinson’s disease psychosis
Initial criteria
- age ≥ 18 years
- diagnosis of Parkinson’s disease (ICD-10: G20)
- Nuplazid is being used for the treatment of hallucinations and delusions (ICD-10: F06.0 or F06.2)
Reauthorization criteria
- prescriber attests that the member has experienced positive clinical response to therapy
Approval duration
12 months