Skip to content
The Policy VaultThe Policy Vault

Ajovy (fremanezumab-vfrm)Medica

Migraine headache prevention in adults

Initial criteria

  • Patient is age ≥ 18 years
  • Patient has ≥ 4 migraine headache days per month prior to initiating a migraine-preventive medication
  • If the patient is currently taking Ajovy, the patient has had a significant clinical benefit from the medication as determined by the prescriber

Reauthorization criteria

  • Patient continues to have a significant clinical benefit from Ajovy as determined by the prescriber

Approval duration

1 year