Payer PolicyActive
Eptinezumab-jjmr (Vyepti)
EVICORE-MEDICAL_DRUG-E7CBCA82
EviCore by Evernorth
Effective: July 1, 2023
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Vyepti (eptinezumab‑jjmr) is covered only for the FDA‑approved preventive treatment of migraine in adults and excludes off‑label uses and concurrent use with other CGRP inhibitors. Approval (initial and renewal, each for 12 months) requires age ≥18, ≥4 migraine days/month, documented failure or intolerance to at least two standard prophylactic agents from different classes, dosing at 100 mg IV every 3 months, and renewal requires objective clinical benefit with supporting documentation of diagnosis, baseline migraine burden, prior trials, and infusion dates.
Coverage Criteria Preview
Key requirements from the full policy
"Vyepti is indicated for the preventive treatment of migraine in adults."
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