Skip to content
The Policy VaultThe Policy Vault

Sympazan (clobazam oral soluble film)Medica

Treatment-refractory seizures/epilepsy

Initial criteria

  • age ≥ 2 years
  • Patient has tried and/or is concomitantly receiving at least two other antiseizure medications
  • Clobazam is prescribed by or in consultation with a neurologist

Reauthorization criteria

  • Patient is currently receiving clobazam and is responding to therapy, as determined by the prescriber (e.g., reduced seizure severity, frequency, and/or duration from baseline)

Approval duration

1 year