vigabatrin — Medica

Initial criteria

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

Reauthorization criteria

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

Approval duration

initial: 3 months; reauth: 1 year