Nuedexta — Medical Mutual

Initial criteria

• Patient has PBA associated with a chronic neurological condition (e.g., amyotrophic lateral sclerosis [ALS], multiple sclerosis [MS], stroke, dementia, traumatic brain injury)
• Nuedexta is prescribed by or in consultation with a neurologist

Reauthorization criteria

• Response to therapy is required for continuation of therapy

Approval duration

initial 90 days; reauth 365 days