[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-288923-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-288923-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","prior-authorization-guide-for-qulipta-and-ubrelvy-help-patients-get-access","Prior Authorization Guide for QULIPTA and UBRELVY - Help Patients Get Access","","Guide for completing prior authorization (PA) for migraine medications QULIPTA (atogepant) and UBRELVY (ubrogepant), including required medical and clinical details. Summarizes dosing, indication, strength options, and criteria for initial approval or continuation of therapy, such as headache-day frequency and migraine diagnosis. Provides key contraindications and warnings, including hypersensitivity and relevant drug-interaction cautions, and includes a quick reference list of common preventive and acute migraine treatments.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/letters/","Letters",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/prior-authorization-guide-for-qulipta-and-ubrelvy-help-patients-get-access/288923/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/prior-authorization-guide-for-qulipta-and-ubrelvy-help-patients-get-access/288923.png","ImageObject",442,249,{"name":42,"@type":43},"Ethan Miller","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-08","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information is needed to submit a prior authorization for QULIPTA or UBRELVY?","Question",{"text":63,"@type":64},"Provide medication and indication details, dosing/strength, and clinical information such as diagnosis and diagnosis-specific code selection. For continuation, clearly define the patient’s response to therapy.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How should headache-day frequency be documented for migraine prior authorization?",{"text":68,"@type":64},"List the number of monthly headache days. Use 4 to 14 headache days per month for episodic migraine and 15+ headache days per month for chronic migraine.",{"name":70,"@type":61,"acceptedAnswer":71},"What are key safety constraints noted for QULIPTA and UBRELVY?",{"text":72,"@type":64},"QULIPTA is contraindicated with hypersensitivity to atogepant or its components, and hypersensitivity reactions including anaphylaxis have been reported. UBRELVY is contraindicated with concomitant use of strong CYP3A4 inhibitors.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},288923,1790439568,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,114,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},17,"Forms",40,"forms",{"id":115,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":116,"slug":117},18,30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":115,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":136,"language":137,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":12,"update_tm":141,"read_time":30},687207017582,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","NATIONALLY COMMERCIALLY INSURED LIVES NOW COVERED1*:  \n89% FOR QULIPTA®  94% FOR UBRELVY ®  \nYour Guide to Prior Authorization (PA)  \nDid you know?  \nOn average, over 85% of ePAs submitted get a result in under 24 hours 1 ~~ ~~ SEE HOW YOU CAN HELP YOUR PATIENTS ACCESS THEIR MEDICATION ~~ ~~  \nePAs=electronic prior authorizations.  \n*Managed Markets Insight & Technology, LLC, a trademark of MMIT. Data as of January 2024 and are subject to change.  \nThis information is presented for informational purposes only and is not a guarantee of coverage, or partial or full payment, by any payers listed and is not intended to provide reimbursement or legal advice. Actual benefits are determined by respective plan administrators. Insurer plans, coverage criteria, and formularies are subject to change without notice. Check each patient’s coverage with applicable insurer. AbbVie does not endorse any individual plans. Formulary coverage does not imply safety or efficacy.  \nQULIPTA INDICATION:  \nQULIPTA® (atogepant) is indicated for the preventive treatment of migraine in adults.  \nUBRELVY INDICATION:  \nUBRELVY® (ubrogepant) is indicated for the acute treatment of migraine with or without aura in adults. UBRELVY is not indicated for the preventive treatment of migraine.  \nPlease see Important Safety Information on page 13. For full Prescribing Information, [please visit ](please visit rxabbvie.com/pdf/QULIPTA_pi.pdf and rxabbvie.com/pdf/UBRELVY_pi.pdf)[rxabbvie.com/pdf/QULIPTA_pi.pdf](please visit rxabbvie.com/pdf/QULIPTA_pi.pdf and rxabbvie.com/pdf/UBRELVY_pi.pdf)[ and ](please visit rxabbvie.com/pdf/QULIPTA_pi.pdf and rxabbvie.com/pdf/UBRELVY_pi.pdf)[rxabbvie.com/pdf/UBRELVY_pi.pdf](please visit rxabbvie.com/pdf/QULIPTA_pi.pdf and rxabbvie.com/pdf/UBRELVY_pi.pdf).  \nHELP YOUR PATIENTS GET ACCESS  \n SECTION 1: Fill in the relevant information for your patient’s PA  \nMEDICAL INFORMATION  \nMedication Name: QULIPTA (atogepant)  \nIndication: Preventive treatment of migraine in adults2  \nStrength(s): QULIPTA is available in a 10 mg, 30 mg, and 60 mg tablet2  \nDosing: One pill taken by mouth once a day2  \nInitial Approval or Continuation of  \nTherapy Designation: If the patient has already received QULIPTA, then request “continuation of therapy.” Clearly define patient’s response to therapy  \nCLINICAL INFORMATION  \nDiagnosis: List the number of headache days the patient experiences monthly  \n• Episodic migraine: 4 to 14 headache days per month3  \n• Chronic migraine: 15+ headache days per month3  \nICD-10/ICD-11 Code(s): See page 6.  \nPhysicians should select the appropriate diseasespecific code(s) based on the patient’s diagnosis  \nPrior Medication: See common migraine medicationstable on page 4. List all therapies the patient has tried for the preventive treatment of migraine  \nMEDICAL INFORMATION  \nMedication name: UBRELVY (ubrogepant)  \nIndication: Acute treatment of migraine with or without aura in adults4  \nStrength(s): UBRELVY is available in a 50 mg anda 100 mg tablet4  \nDosing: One pill taken as needed. A second dose may be administered at least 2 hours after the initial dose if symptoms persist4  \nInitial Approval or Continuation of  \nTherapy Designation: If the patient has already received UBRELVY, then request “continuation of therapy.” Clearly define patient’s response to therapy  \nCLINICAL INFORMATION  \nDiagnosis: Migraine with or without aura  \nICD-10/ICD-11 Code(s): See page 6.  \nPhysicians should select the appropriate diseasespecific code(s) based on the patient’s diagnosis  \nPrior Medication: See common migraine medicationstable on page 5. List all therapies the patient has tried for the acute treatment of migraine  \nIMPORTANT SAFETY INFORMATION FOR QULIPTA®  \nCONTRAINDICATIONS  \nQULIPTA is contraindicated in patients with a history of hypersensitivity to atogepant or any of the components of QULIPTA.  \nPlease see additional Important Safety Information on page 13. For full Prescribing Information, please visit [rxabbvie.com/pdf/Q","cbCairWIE2ayZgqI","https://ap.wps.com/l/cbCairWIE2ayZgqI","pdf",2558699,9,"English","# Your Guide to Prior Authorization (PA)\n## Section 1: Fill in the Relevant Information for Your Patient’s PA\n### Medical Information\n### Clinical Information\n## Important Safety Information for QULIPTA and UBRELVY\n## Your Quick Reference Guide of Common Treatments for Migraine","[{\"question\":\"What information is needed to submit a prior authorization for QULIPTA or UBRELVY?\",\"answer\":\"Provide medication and indication details, dosing/strength, and clinical information such as diagnosis and diagnosis-specific code selection. For continuation, clearly define the patient’s response to therapy.\"},{\"question\":\"How should headache-day frequency be documented for migraine prior authorization?\",\"answer\":\"List the number of monthly headache days. Use 4 to 14 headache days per month for episodic migraine and 15+ headache days per month for chronic migraine.\"},{\"question\":\"What are key safety constraints noted for QULIPTA and UBRELVY?\",\"answer\":\"QULIPTA is contraindicated with hypersensitivity to atogepant or its components, and hypersensitivity reactions including anaphylaxis have been reported. UBRELVY is contraindicated with concomitant use of strong CYP3A4 inhibitors.\"}]","Prior Authorization Guide for QULIPTA and UBRELVY - Help Patients Get Access | PDF",1789634228]