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AqneursaMedica

Niemann-Pick disease type C

Initial criteria

  • age ≥ 4 years
  • patient weighs ≥ 15 kg
  • patient has one or more neurologic symptom(s) of Niemann-Pick disease type C (e.g., loss of motor function, difficulty swallowing, speech or cognitive impairment)
  • diagnosis established by genetic test showing biallelic pathogenic variants in NPC1 or NPC2 gene
  • medication prescribed by or in consultation with a geneticist, endocrinologist, metabolic disorder subspecialist, neurologist, or a physician specializing in the treatment of Niemann-Pick disease type C or related disorders

Reauthorization criteria

  • according to prescriber, patient has derived benefit from treatment defined as disease stabilization, slowed progression, or improvement
  • medication prescribed by or in consultation with a geneticist, endocrinologist, metabolic disorder subspecialist, neurologist, or a physician specializing in the treatment of Niemann-Pick disease type C or related disorders

Approval duration

initial: 6 months; reauth: 1 year