Nurtec ODT — Medical Mutual

Initial criteria

• Patient has a diagnosis of migraine
• Patient age ≥ 18 years
• Patient has tried at least one triptan therapy OR has a contraindication to triptan therapy according to the prescriber

Reauthorization criteria

• If the patient is currently taking a CGRP antagonist, the patient has had a significant clinical benefit from the medication as determined by the prescriber

Approval duration

initial 3 months; reauth 1 year