approved, initial authorization will be for six (6) months.
Aimovig (erenumab) is considered medically necessary in members meeting the
18 years of age or older AND
of migraine headaches AND
being used for the prevention of migraines AND
Documentation of at least eight (8) migraines per month AND
had inadequate response to an adequate trial (3 months) of a product from at
least two of the drug classes below:
Blockers (e.g. atenolol, propranolol)
Anticonvulsants (e.g. topiramate, gabapentin, divalproex)
Antidepressants (e.g. amitriptyline, venlafaxine)
Channel Blockers (e.g. verapamil)
completed an adequate trial (3 months) of at least one triptan (e.g. sumatriptan,
naratriptan, rizatriptan, eletriptan, zolmitriptan, almotriptan, frovatriptan).
not be using Aimovig with Botox for prevention of migraines.
decrease of > 50% in migraine frequency from baseline AND
use of acute migraine medications AND
therapy with Botox.