Drug - stiripentol (Diacomit) [Biocodex]
May 2019
Therapeutic Area - Antiepileptic
Stiripentol may be covered by Minnesota Health Care Programs (MHCP) if ALL of the following conditions are met:
The prior authorization criteria above for imported Diacomit will be discontinued as of May 31, 2019. Please see below for new coverage policy for FDA-approved Diacomit effective June 1, 2019
MHCP Provider Call Center 651-431-2700 or 800-366-5411
In light of Biocodex’s recent launch of FDA-approved Diacomit (stiripentol) in the US, Minnesota Fee-for-Service Medical Assistance will implement new Diacomit coverage policy beginning June 1, 2019.
What is changing?
Beginning June 1, 2019, Minnesota Fee-for-Service Medical Assistance (FFS MA) will cover only the FDA-approved Diacomit. On or after June 1, 2019, FFS MA will no longer cover imported-Diacomit previously dispensed by Caligor Rx Inc.
What do prescribers need to do?
In order to obtain coverage for new or refill Diacomit prescription dispensed on or after June 1, 2019, a prior authorization must be obtained by faxing the MHCP Prescription Drug PA Review Agent:
MHCP Prescription Drug PA Review Agent
Hours: Monday–Friday, 8:00 a.m. to 5:30 p.m. Central Time
Fax: 866-648 4574
Phone: 866-205 2818
Prior authorization requests for refill Diacomit prescriptions will be granted for all patients with active FFS MA coverage. Prior authorization request for new Diacomit prescriptions will be granted if patients have active FFS MA coverage AND meet prior authorization criteria for new drugs.
In order to arrange for FDA-approved Diacomit to be dispensed and shipped to patients, prescribers will need to contact:
Diacomit Support Services (US Bioservices)
Phone: 833-248-0467 (Monday-Friday, 7 AM to 7 PM CST)
FFS MA members with Other Insurance Coverage/Third Party Liability (TPL)
FFS MA members with Other Insurance Coverage/Third Party Liability (TPL) must obtain coverage of FDA-approved Diacomit through primary insurance first.
If providers have any questions regarding this change in coverage policy, please contact:
MHCP Provider Call Center
Hours: Monday–Friday, 8:00 a.m. to 4:30 p.m. Central Time
Phone: 651-431-2700 or 800-366-5411