Vyepti (eptinezumab-jjmr)
Billing
Code: J3032
Description: Inj. eptinezumab-jjmr 1 mg
Unit: 1 mg
Payment: $16.888
Pay quarter: Q1 2023
Dosage and Frequency
Migraine
• 100mg IV every 3 months
• 100mg IV every 3 months
Calculate drug reimbursement
Total Reimbursement:
$1,790.13(ASP: $1,688.80, Margin: $101.33)
Code:
J3032# Units to bill:
100Prior Authorization
Prior auth criteria for Vyepti may include but is not limited to:
1. Vyepti is indicated for the preventive treatment of migraine in adults aged 18 years or older who have a history of 4 or more migraine days per month.
2. Vyepti treatment should be initiated and supervised by a health care provider who has experience in the diagnosis and treatment of migraine.
3. Vyepti is contraindicated in patients with hypersensitivity to eptinezumab-jjmr or any of its components.
4. Vyepti should not be administered to patients with clinically significant active infection or a history of chronic infection.
5. Patients should not receive Vyepti if they have had a serious allergic reaction to any other monoclonal antibody.
6. Patients should not receive Vyepti if they have a current or previous history of demyelinating disease or other autoimmune disorder.
7. Patients should not receive Vyepti if they have a history of heparin-induced thrombocytopenia or thrombosis.
Insurance prior auth guidelines:
Billable NDCs
67386-0130-51
Vyepti (LUNDBECK PHARMACETICALS, LLC)
100 MG
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