UnitedHealthcare
Piqray (300 MG Daily Dose) (alpelisib)
Drugs for Cancer : Drugs for Cancer
  • Quantity Limit: 2 capsules per 1 day(s).
  • Quantity Limit: 1 capsule per 1 day(s).
  • Step Therapy: ST Required
  • Prior Authorization: Migraine:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)
    Reauthorization Required: Yes

    Migraine Prevention:
    Documented Diagnosis: Yes
    Age Requirement: >= 18
    Duration: 6 Month(s)