Eptinezumab-jjmr

This policy covers intravenous eptinezumab‑jjmr (Vyepti) for preventive treatment of migraine in adults (≥18) with episodic or chronic migraine, including patients whose migraines are refractory to at least two non‑CGRP prophylactic medications from different drug classes. Coverage is limited to FDA‑labeled IV use (administered every 3 months), excludes acute treatment and concurrent use with other preventative CGRP therapies, is subject to the member’s benefit plan, and off‑label uses require support from two peer‑reviewed articles.

"Coverage of any FDA‑approved drug when prescribed for a use recognized as safe and effective in one or more standard medical reference compendia adopted by the U."

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