Zavzpret (zavegepant) — Highmark
acute migraine headaches with or without aura
Preferred products
- generic oral sumatriptan
- generic oral rizatriptan
- generic oral zolmitriptan
- generic sumatriptan nasal spray
Initial criteria
- Member age ≥ 18 years
- Diagnosis of migraine (ICD-10: G43), classified as acute migraine headaches with or without aura
- Meets one of the following: (a) therapeutic failure, contraindication, or intolerance to one of the following — generic oral sumatriptan OR generic oral rizatriptan OR generic oral zolmitriptan; OR (b) prescriber attests member experiences significant nausea and vomiting and requires non-oral route AND member has experienced therapeutic failure, contraindication, or intolerance to generic sumatriptan nasal spray
- 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 positive clinical response to therapy
Approval duration
initial 6 months; reauthorization 12 months