Skip to content
The Policy VaultThe Policy Vault

ZenzediMedica

Attention Deficit Hyperactivity Disorder

Initial criteria

  • Patient is ≥ 18 years of age AND meets one of the following:
  • 1. Attention Deficit Hyperactivity Disorder (approve for 1 year).
  • OR
  • 2. Binge Eating Disorder (approve only Vyvanse [brand or generic] for 1 year if patient is > 18 years).
  • OR
  • 3. Narcolepsy (approve for 1 year).
  • OR
  • 4. Depression, adjunctive/augmentation treatment in an adult (approve for 1 year if patient is concurrently receiving other medication therapy for depression).
  • OR
  • 5. Fatigue associated with cancer and/or its treatment (approve for 1 year).
  • OR
  • 6. Idiopathic hypersomnolence (approve for 1 year if diagnosis is confirmed by a sleep specialist physician or sleep center).

Reauthorization criteria

  • Same criteria as initial approval; reapproval may be granted if current clinical rationale remains and indication continues to meet approval criteria.

Approval duration

1 year