Lacosamide is a prescription medication used to treat partial-onset seizures in adults and children. The criteria for lacosamide approvals vary depending on the health insurance plan. However, there are some general criteria that are commonly used across different plans.
According to Drug Patent Watch [1], lacosamide is approved by the FDA for the treatment of partial-onset seizures in patients with epilepsy who are 17 years of age and older. The drug is available in tablet and injection form, and it works by reducing the activity of certain brain cells that cause seizures.
The United Healthcare Prior Authorization Notification [2] states that prior authorization is required for lacosamide tablets and injection. The criteria for approval include a diagnosis of partial-onset seizures, failure of at least two other antiepileptic drugs, and the absence of a contraindication to lacosamide therapy. The notification also specifies that the maximum dose of lacosamide should not exceed 400 mg/day.
Similarly, the Superior HealthPlan Pharmacy Policy [3] states that prior authorization is required for lacosamide tablets and injection. The criteria for approval include a diagnosis of partial-onset seizures, failure of at least two other antiepileptic drugs, and the absence of a contraindication to lacosamide therapy. The policy also specifies that the maximum dose of lacosamide should not exceed 400 mg/day.
In conclusion, the criteria for lacosamide approvals generally include a diagnosis of partial-onset seizures, failure of at least two other antiepileptic drugs, and the absence of a contraindication to lacosamide therapy. The maximum dose of lacosamide should not exceed 400 mg/day. However, it is important to note that the specific criteria may vary depending on the health insurance plan.
Sources:
[1] https://www.drugpatentwatch.com/p/tradename/LACOSAMIDE
[2] https://www.uhcprovider.com/content/dam/provider/docs/public/prior-auth/drugs-pharmacy/commercial/r-z/PA-Notification-Vimpat.pdf
[3] https://www.superiorhealthplan.com/content/dam/centene/Superior/policies/pharmacy-policies/CP.PMN.155-09012021.pdf