AMCP Market Insights: Payer best practices for timely diagnosis and optimal management of idiopathic hypersomnia.

Flavin, Bridget; Wolff, Denise; Contreras, Zachary; Haumschild, Ryan; Kimmel, Diana; Kobernick, Michael; Rahman, Farzana · J Manag Care Spec Pharm · 2025

expert_opinion · Level V

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Abstract

Idiopathic hypersomnia (IH) is a chronic, neurologic disorder with a primary symptom of excessive daytime sleepiness. There are challenges to timely, accurate diagnosis of IH and, therefore, to optimal management. To better understand these challenges and identify opportunities, AMCP Market Insights virtually convened an expert panel of managed care stakeholders in April 2024. Key insights from the discussion related to addressing diagnostic challenges in IH, making coverage decisions for medications used in IH, and implementing coverage criteria for medications used in IH. Suggested payer best practices in IH also emerged from the discussion.

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