XYREM® (sodium Oxybate, GHB) - AZBlue
PRECERTIFICATION REQUEST FORM Fax completed form to: (602) 864-3126, or XYREM® (sodium oxybate, GHB) Section 1: Yes No Excessive daytime sleepiness (EDS) in Narcolepsy (without Cataplexy) that has failed: ... Fetch Content
Xyrem (sodium Oxybate) - SummaCare
XYREM (MEDICARE ONLY) 7/1/10 Page 1 of 1 Xyrem® (sodium oxybate) Criteria for Coverage - Medicare Part D Only: The patient has a confirmed diagnosis of narcolepsy with cataplexy or excessive daytime sleepiness. Duration of Authorization: ... Doc Retrieval
XYREM (Sodium Oxybate) - Sterlingretireescripts.com
XYREM (Sodium oxybate) Covered Uses: All medically accepted indications not otherwise excluded from Part D. b. documentation of symptoms of excessive daytime sleepiness associated with narcolepsy, c. history of failure, contraindication, ... Access Full Source
Pre - PA Allowance - Caremark
XYREM (sodium oxybate) Pre - PA Allowance None _____ Prior-Approval Requirements Age 18 years of age or older Diagnoses Patient must have ONE of the following Excessive daytime sleepiness (EDS) in narcolepsy AND ALL of the following: 1. ... Visit Document
MEDICARE PART D COVERAGE CRITERIA XYREM (sodium Oxybate)
XYREM (sodium oxybate) Diagnoses Considered for Coverage: • Treatment of cataplexy in patients with narcolepsy Treatment of excessive daytime sleepiness with narcolepsy: • Narcolepsy is confirmed by sleep study, AND ... Get Doc
I. Requirements For Prior Authorization Of Xyrem
I. Requirements for Prior Authorization of Xyrem . Has a diagnosis of narcolepsy with excessive daytime sleepiness (EDS) and/or cataplexy as confirmed by a sleep study followed by multiple sleep latency testing (MSLT) AND . 3. ... Fetch Here
Prior Authorization Approval Criteria - FCHP
Treatment of cataplexy and excessive daytime sleepiness in patients with narcolepsy Available Dosage Form: Patient must be clinically diagnosed with narcolepsy and have cataplexy or excessive Almost all patients receiving Xyrem under clinical trials were also receiving CNS ... Retrieve Content
Pharmacy Policy Bulletin - Highmarkbcbswv.com
Pharmacy Policy Bulletin Category: Prior Authorization Number: J-129 Xyrem is available through the Xyrem Success Program Sodium oxybate is used to treat excessive daytime sleepiness in patients with narcolepsy, as ... Fetch Content
XYREM® (Sodium Oxybate) - Fdhc.state.fl.us
XYREM® (Sodium Oxybate) LENGTH OF AUTHORIZATION: Initial therapy may be approved for up to 3 months. For excessive daytime sleepiness, must have tried and failed/intolerant to at least one formulary/preferred stimulant treatment, ... Return Doc
BENEFIT DESCRIPTION AND LIMITATIONS OF COVERAGE
Treatment of cataplexy and excessive daytime sleepiness in patients with daytime sleepiness (EDS) was improved in all Xyrem groups. The higher doses of Xyrem also demonstrated a significant reduction in the number of inadvertent ... Get Content Here
Narcolepsy 2 - YouTube
References: http://www.nhlbi.nih.gov/health/healt http://www.webmd.com/sleep-disorders ... View Video
Ritalin May Help For Narcolepsy And Other Sleep Disorders
(ADD) and attention deficit hyperactivity disorder (ADHD), as well as the excessive daytime sleepiness associated with narcolepsy and chronic fatigue syndrome. Xyrem for Narcolepsy Treatment; Should You Try Ambien For a Better Night's Sleep? Our Expert Recommends. ... Read Article
DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service
NDA 21-196/S-005 Orphan Medical, Inc. solution for the treatment of excessive daytime sleepiness in patients with narcolepsy. We have completed our review of this application, Xyrem® Success Program For Physicians (Book, ... Access Doc
XYREM (sodium Oxybate) - Wellcarepdp.com
1. Treatment of excessive daytime sleepiness in patients with narcolepsy: a. Submission of sleep study confirming the diagnosis of narcolepsy, as defined by the International ... Access This Document
MY WEEKLY DIARY - xyrem.com
Narcolepsy: Excessive daytime sleepiness (EDS) | Cataplexy 1 2 3 ©2016 Jazz Pharmaceuticals plc or its subsidiaries US-NDS-0154 Rev0415 My Achievements List any personal achievements you have made during treatment: My Setbacks ... Access This Document
Does Narcolepsy Go Away - Sleep Disorders
This sleep disorder consists of excessive daytime sleepiness and sometimes weakness with emotion, Does narcolepsy go away? Xyrem for Narcolepsy Treatment; ... Read Article
List Of Off-label Promotion Pharmaceutical Settlements ...
Under the FDCA and agreed to pay $20 million to resolve all civil claims and criminal charges in connection with Xyrem, Provigil was initially approved to treat excessive daytime sleepiness resulting from narcolepsy, ... Read Article
Xyrem (Medicare Prior Authorization)
Xyrem (Medicare Prior Authorization) This fax machine is located in a secure location as required by HIPAA regulations. Does the patient experience excessive daytime sleepiness with symptoms that limit the ability to perform normal daily activities? Y N . Comments: ... Read More
Xyrem (sodium Oxybate) Prior Authorization And Quantity Limit ...
FDA Indication: Sodium oxybate (Xyrem) is indicated for treatment of excessive daytime sleepiness (EDS) and cataplexy in patients with narcolepsy. Safety and effectiveness in patients under 18 years of age have not been established. 1. ... Access Doc
Sodium Oxybate (Xyrem - Cambsphn.nhs.uk
EJ18 Sodium Oxybate ( Xyrem narcolepsy, particularly excessive daytime sleepiness, do not respond to standard medication such as Modafinil and Dexamphetamine. The recommendation to start treatment ... View This Document
XYREM (sodium Oxybate) - Wellcarepdp.com
XYREM (sodium oxybate) Covered uses All FDA-approved indications not otherwise excluded from Part D. Exclusion Criteria Required Medical Information 1. Treatment of excessive daytime sleepiness in patients with narcolepsy: a. Submission of sleep study confirming the diagnosis of narcolepsy, as ... Access Full Source
UNIFORM PHARMACY PRIOR AUTHORIZATION REQUEST FORM - RMHP
DOSAGE/ADMINISTRATION Adult Dosing (safety and efficacy has not been determined for pediatric patients less than 16 years): Cataplexy and narcolepsy, and excessive daytime sleepiness: ... Retrieve Document
Xyrem (sodium Oxybate) - Anthem
Xyrem use has resulted in a reduction in excessive daytime sleepiness (EDS) as measured by improvement in Epworth Sleepiness Scale (ESS) measurements or Maintenance of Wakefulness Test (MWT). ... Access Full Source
The Four Defining Features Of Narcolepsy - Sleep Disorders
Narcolepsy is a disorder of excessive daytime sleepiness, but it also has four features that make it unique among the sleep disorders. Narcolepsy is a disorder of excessive daytime sleepiness, ... Read Article
Therapeutic Class Overview Narcolepsy Agents (non-stimulant)
The Xyrem ® Success Program Excessive daytime sleepiness and irresistible episodes of sleep • Modafinil should be prescribed when excessive daytime sleepiness is present. Modafinil should be dosed as 100 to 400 mg/day, given once in the morning or twice daily. ... Retrieve Doc
No comments:
Post a Comment