Trudhesa — United Healthcare
moderate to severe migraine headaches with or without aura
Preferred products
- sumatriptan
- zolmitriptan
Initial criteria
- Diagnosis of moderate to severe migraine headaches with or without aura
- AND History of failure (after at least 3 migraine episodes and a minimum of a 30-day trial), contraindication, or intolerance to one of the following oral triptans (document duration of trial): almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt/Maxalt-MLT), sumatriptan (Imitrex), zolmitriptan (Zomig)
- AND History of failure (after at least 3 migraine episodes and a minimum of a 30-day trial), contraindication, or intolerance to both of the following: sumatriptan nasal spray (generic Imitrex nasal spray) AND Zomig nasal spray (zolmitriptan)
Approval duration
12 months