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Medicare AdvantagePrior AuthMedium impact

Nurtec™ ODT (rimegepant) (Revised)

Humana·Neurology, Family Medicine, Internal Medicine·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage updated prior authorization criteria for Nurtec ODT (rimegepant) for migraine treatment. For acute migraines, patients must try Ubrelvy first; for prevention, patients must fail two of three specific migraine preventatives (Aimovig, Emgality, or Qulipta).

Action Required

Action needed
Immediately: Update prior authorization workflows for Nurtec ODT prescriptions for Humana Medicare Advantage patients. Verify patients have documented trial/failure of Ubrelvy for acute migraine treatment, or failure of two preventatives (Aimovig, Emgality, Qulipta) for migraine prevention. Train clinical staff to document these requirements before submitting prior auth requests.