Ajovy (fremanezumab-vfrm) — Medica

Initial criteria

• Patient is age ≥ 6 years and < 18 years
• Patient has ≥ 4 and < 15 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