Nurtec ODT (rimegepant) — Point32Health
acute treatment of migraine with or without aura
Initial criteria
- Diagnosis of migraine with or without aura
- Will be used for the acute treatment of migraine (NOT prevention)
- Patient age ≥ 18 years
- Patient has tried and failed therapy with TWO triptans (e.g., sumatriptan, rizatriptan, zolmitriptan) OR has a contraindication to ALL triptans
- Medication will not be used in combination with another CGRP antagonist used for acute migraine treatment (e.g., Ubrelvy)
Reauthorization criteria
- Drug is prescribed for the same condition as initial request
- Patient has experienced a positive response to therapy
- Medication will not be used in combination with another CGRP antagonist used for the same condition
Approval duration
6 months initial, 12 months reauth