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Elyxyb — Blue Cross Blue Shield of Kansas

Acute treatment of migraine with or without aura in adults

Preferred products

  • Migranal

Initial criteria

  • Prescribed by a licensed clinician
  • Patient age ≥ 18 years
  • Diagnosis of migraine with aura, migraine without aura, or chronic migraine according to ICHD-3 criteria
  • Patient has either of the following: (a) contraindication to or inability to tolerate triptans OR (b) inadequate response to two or more oral triptans as determined by a validated acute treatment patient-reported outcome questionnaire (Migraine Functional Impact Questionnaire [mTOQ], Migraine Assessment of Current Therapy [MigraineACT], Patient Perception of Migraine Questionnaire-Revised [PPMQ-R], Functional Impairment Scale [FIS], or Patient Global Impression of Change [PGIC]) or by clinician attestation