| Western Health Advantage |
| Emgality (300 MG Dose) (galcanezumab-gnlm) |
| Drugs for the Nervous System : Drugs for Migraine Headaches |
- Quantity Limit: 30 day supply per 1 fill(s).
- Step Therapy: ST Multiple Generics
- Cluster Headache:
Age Requirement: >= 18
Duration: 3 Month(s)
Specialist Required: Yes
Documented Diagnosis: Yes
Medical Test Required: No
Specialist Type(s): 1 of Headache Specialist;Neurologist;Pain Management Specialist
Reauthorization Required: Yes
Duration of Reauthorization: = 1 year(s)
Migraine Prevention:
Age Requirement: >= 18
Duration: 3 Month(s)
Documented Diagnosis: Yes
- Prior Authorization: Cluster Headache:
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 3 Month(s)
Reauthorization Required: Yes
Migraine Prevention:
Documented Diagnosis: Yes
Age Requirement: >= 18
Duration: 3 Month(s)
- PA Required
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