Sympazan — United Healthcare
Patients unable to ingest solid dosage forms requiring clobazam
Preferred products
- clobazam oral suspension (generic Onfi)
Initial criteria
- Patient is unable to ingest a solid dosage form (e.g. an oral tablet or capsule) due to age OR oral/motor difficulties OR dysphagia OR utilizes a feeding tube for medication administration
- AND Patient has a history of trial and failure or intolerance to clobazam oral suspension (generic Onfi)
Approval duration
12 months