frovatriptan (Frova) — CareFirst (Caremark)
migraine headache
Initial criteria
- Patient does NOT have confirmed or suspected cardiovascular OR cerebrovascular disease OR uncontrolled hypertension
- Medication overuse headache has been considered AND ruled out
- Patient meets ONE of the following: (1) Patient is currently using migraine prophylactic therapy OR (2) Patient is unable to take migraine prophylactic therapies due to an inadequate treatment response, intolerance or contraindication [Examples include divalproex sodium, topiramate, valproate sodium, metoprolol, propranolol, timolol, atenolol, nadolol, candesartan, amitriptyline, venlafaxine, erenumab, fremanezumab, galcanezumab, eptinezumab, rimegepant, atogepant]
- Patient meets ONE of the following: (1) Requested drug is NOT being used concurrently with another triptan 5‑HT1 agonist OR (2) Requested drug is being used concurrently with another triptan 5‑HT1 agonist AND patient requires more than one triptan 5‑HT1 agonist due to clinical need for differing routes of administration
Approval duration
12 months (MMT 903-J) or 36 months (J)