Vigadrone — United Healthcare
infantile spasms (≤2 years old)
Initial criteria
- ALL of the following: Diagnosis of partial-onset seizures; Used as adjunctive therapy; Not used as primary treatment; Patient has had inadequate response to several (at least three) alternative anticonvulsants OR Diagnosis of infantile spasms and age ≤2 years OR continuation of prior therapy for a seizure disorder
Reauthorization criteria
- Documentation of positive clinical response to therapy
Approval duration
12 months