Nurtec ODT (rimegepant) — Highmark

Initial criteria

• Member meets criteria specified for preventive CGRP inhibitors
• If using two chemically distinct CGRP inhibitors for preventive and acute use, prescriber attests benefits outweigh risks of concurrent use

Reauthorization criteria

• Prescriber attests the member has experienced ≥50% reduction in migraine days per month from baseline OR reduction of ≥4 migraine days per month from baseline
• Subsequent reauthorizations are subject to sustained improvements noted above

Approval duration

initial 6 months; reauthorization 12 months