Western Health Advantage
Epidiolex (cannabidiol)
Drugs for the Nervous System : Drugs for Seizures /Personality Disorder/Nerve Pain
  • Available through Specialty Pharmacy;
  • Quantity Limit: 30 day supply per 1 fill(s).
  • Step Therapy: Neurology: Epilepsy:
    ST Multiple Generics

  • PA Required
  • Prior Authorization: Neurology: Epilepsy:
    Documented Diagnosis: Yes
    Age Requirement: >= 2
    Duration: 1 year(s)
    Reauthorization Required: Yes

  • Neurology: Epilepsy:
    Age Requirement: >= 2
    Duration: 1 year(s)
    Specialist Required: Yes
    Documented Diagnosis: Yes
    Medical Test Required: No
    Specialist Type(s): Neurologist
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 year(s)
    Diagnosis Type(s): 1 of Dravet syndrome;Epilepsy;Intractable Seizures;Seizures Associated with Lennox-Gastaut Syndrome (LGS)
    Used as Adjunctive Treatment: No
    Duration of Failure or Adjunctive Treatment with Other Antiepileptic Product: N/A
    Documented history of persisting seizures after titration to highest tolerated dose of each AED.: No
    Lack of compliance as a reason for treatment failure has been ruled out: No
    Documentation of treatment failure due to intolerable side effects.: No
    Supporting Documentation Requirements: Medication History
    Positive Response to Therapy Required for Reauth: Yes
    Treatment for Age 17 years or older: No
    Treatment for Age 1-16 years old: Yes
    History of >= to 30 day trial of other AED required: No
    Reapproval based on response: Yes