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The Policy VaultThe Policy Vault

EpidiolexMedical Mutual

Treatment-Refractory Seizures/Epilepsy (CDKL5 deficiency disorder; Dup15q; Aicardi; Doose syndromes; febrile infection-related epilepsy syndromes; focal epilepsy; Sturge-Weber syndrome; lissencephaly; cortical malformation/dysplasia; epilepsy with myoclonic absences)

Initial criteria

  • Patient is age ≥ 1 year
  • Patient has tried or is concomitantly receiving at least two other antiseizure medications
  • Medication is prescribed by or in consultation with a neurologist

Reauthorization criteria

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

Approval duration

1 year