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Aptiom (eslicarbazepine)United Healthcare

seizures associated with cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder

Preferred products

  • Carbamazepine
  • Divalproex
  • Gabapentin
  • Lamotrigine
  • Levetiracetam
  • Oxcarbazepine
  • Phenytoin
  • Pregabalin
  • Topiramate
  • Valproic acid
  • Zonisamide

Initial criteria

  • Diagnosis of partial-onset seizures (Aptiom or Xcopri) OR seizures associated with CDKL5 deficiency disorder confirmed with genetic testing (Ztalmy)
  • History of ≥ 8 week trial of at least two of the following (any release formulation qualifies): Carbamazepine, Divalproex, Gabapentin, Lamotrigine, Levetiracetam, Oxcarbazepine, Phenytoin, Pregabalin, Topiramate, Valproic acid, Zonisamide
  • AND one of the following: (a) Both documented history of persisting seizures after titration to highest tolerated dose with each medication trial AND lack of compliance ruled out; OR (b) Documentation of failure due to intolerable side effects AND reasonable efforts made to minimize side effects

Reauthorization criteria

  • Continuation of prior therapy for a seizure disorder

Approval duration

12 months