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Vyepti (eptinezumab-jjmr)


Billing

Code: J3032

Description: Inj. eptinezumab-jjmr 1 mg

Unit: 1 mg

Payment: $17.443

Pay quarter: Q3 2023


Medicare history

Dosage and Frequency

Migraine

• 100mg IV every 3 months

Calculate drug reimbursement


Total Reimbursement:

$1,848.96

(ASP: $1,744.30, Margin: $104.66)


Code:

J3032

# Units to bill:

100

Prior 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:

Aetna

United Healthcare

Anthem

Cigna


Billable NDCs

67386-0130-51

Vyepti (LUNDBECK PHARMACETICALS, LLC)

100 MG



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