Sunosi (solriamfetol) — United Healthcare

Initial criteria

• Diagnosis of obstructive sleep apnea as confirmed by sleep study (unless the prescriber provides justification confirming that a sleep study would not be feasible)
• AND Standard treatments for the underlying airway obstruction (e.g., continuous positive airway pressure [CPAP], bi-level positive airway pressure [BiPAP]) have been used for one month or longer
• AND Patient is fully compliant with ongoing treatment(s) for the underlying airway obstruction

Reauthorization criteria

• Reduction in symptoms of excessive daytime sleepiness associated with Sunosi therapy
• AND Patient continues to be fully compliant with ongoing treatment(s) for the underlying airway obstruction (e.g. CPAP, BiPAP)

Approval duration

12 months