Qulipta (atogepant) — Medica

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 Qulipta, patient has had a significant clinical benefit from the medication as determined by the prescriber
• Do NOT approve for concurrent use with another calcitonin gene-related peptide (CGRP) inhibitor being prescribed for migraine headache prevention

Reauthorization criteria

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

Approval duration

1 year