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MEDICAL NECESSITY GUIDELINE DEPARTMENT: Pharmacy DOCUMENT NAME: armodafinil (NuvigilĀ®) PAGE: 1 of 5 REFERENCE NUMBER: CP.PMN.35
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Document Date: 2014-10-31 15:03:48


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City

Reading / /

Company

Centene / /

Facility

Pharmacy DOCUMENT NAME / POLICY AND PROCEDURE APPROVAL Pharmacy / Pharmacy Operations / /

IndustryTerm

literature search / healthcare / treatment of narcolepsy / documented failure / /

MedicalCondition

serious rash / Stevens-Johnson syndrome / severe hepatic disease / severe depression / F. MS fatigue / MS-Related Fatigue / MS fatigue / Obstructive sleep apnea/hypopnea syndrome / hallucinations / depression / Narcolepsy / mania / Shift work sleep disorder / alcoholism / /

MedicalTreatment

continuous positive airway pressure / concomitant therapy / /

Organization

POLICY AND PROCEDURE APPROVAL Pharmacy & Therapeutics Committee / FDA / National Multiple Sclerosis Society / MEDICAL NECESSITY GUIDELINE DEPARTMENT / EFNS Task Force / /

Position

file V.P. / V.P. / Chief Medical Officer / /

Product

Nuvigil / modafinil / Provigil / /

URL

http /

SocialTag