GOCOVRI (PDF)
Defines medical necessity criteria, initial and continued authorization, dosing limits, exclusions, and therapeutic alternatives for extended-release amantadine (Gocovri) for dyskinesia and 'off' episodes in Parkinson's disease across Commercial, HIM, and Medicaid lines.
Removed Osmolex ER from policy due to discontinuation; for PD with 'off' episodes, moved failure of immediate-release amantadine within the overall failure of two PD adjunct drugs; added step therapy bypass for IL HIM per IL HB 5395; aligned continued therapy requirement for concurrent carbidopa/levodopa; revised commercial approval durations to 12 months; references updated.
Changed commercial approval duration to 12 months (from length of benefit) earlier in 2021/2022 updates.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.