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Xcopri (cenobamate)Highmark

partial-onset seizures (focal seizures)

Initial criteria

  • age ≥ 18 years
  • diagnosis of partial-onset seizures (ICD-10: G40.0-G40.2)
  • therapeutic failure or intolerance to at least two other antiepileptic drugs indicated for partial-onset seizures, OR all are contraindicated

Reauthorization criteria

  • prescriber attests that the member has experienced a reduction in seizure frequency from baseline

Approval duration

12 months