Qulipta — United Healthcare
preventive treatment of migraine
Initial criteria
- Diagnosis of migraines
- Used for preventive treatment of migraines
- Medication will not be used in combination with another CGRP antagonist or inhibitor used for the preventive treatment of migraines (e.g., Aimovig, Ajovy, Emgality, Vyepti, Nurtec ODT)
Reauthorization criteria
- Documentation of positive clinical response to therapy
- Medication will not be used in combination with another CGRP antagonist or inhibitor used for the preventive treatment of migraines (e.g., Aimovig, Ajovy, Emgality, Nurtec ODT, Vyepti)
Approval duration
12 months