Ajovy (fremanezumab-vfrm) — Point32Health
preventive treatment of migraine
Initial criteria
- Diagnosis of migraine
- Patient experiences ≥ 4 migraines per month
- Patient age ≥ 18 years
- Patient has tried and failed TWO prophylactic drugs, each from a different drug class (Antidepressants, Beta-blockers, Anticonvulsants)
- Medication will not be used in combination with another CGRP antagonist used for migraine prevention (e.g., Aimovig, Emgality, Ajovy, Nurtec ODT, Qulipta)
- If the request is for Ajovy, patient has tried and failed therapy with both Aimovig AND Emgality
Reauthorization criteria
- Drug is prescribed for the same condition as initial request
- Patient has experienced a positive response to therapy (e.g. reduction in pain, photophobia, phonophobia, nausea, or decrease in frequency of headaches or migraine attacks)
- Medication will not be used in combination with another CGRP antagonist used for the same condition
Approval duration
12 months