Qulipta (atogepant) — Point32Health

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)

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

12 months