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Anti-CGRP receptor monoclonal antibody

Aimovig (erenumab) Letter of Medical Necessity

Aimovig (erenumab) requires documented migraine frequency and failure of two oral preventives per most payer policies. A headache diary is essential.

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FDA-Approved Indications

  • ● migraine prevention in adults

Why Aimovig Prior Authorization Gets Denied

The most common denial reasons across major payers:

  1. 1. Headache diary missing
  2. 2. Two preventive trials not documented
  3. 3. Migraine days not specified

What to Include in a Aimovig Letter of Medical Necessity

Document migraine days per month, MIDAS or HIT-6 score, prior preventive trials with duration and outcomes, and the AHS criteria supporting CGRP therapy.

Key clinical evidence to cite:

  • ✓ STRIVE, ARISE, LIBERTY trials

Relevant guidelines:

  • 📖 AHS Position Statement on CGRP Therapies

Aimovig Prior Authorization Criteria

Standard criteria across major US payers for Aimovig. Specific criteria vary by plan — RxCheckUp tailors each LMN to your patient's exact payer policy.

Typical step therapy requirements:

  • → Two preventive trials not documented

Required documentation:

  • ✓ ICD-10 diagnosis code with specificity
  • ✓ Prior therapy history with dates, doses, and discontinuation reasons
  • ✓ Specialist evaluation (where applicable)
  • ✓ Baseline disease activity or biomarker results
  • ✓ Clinical rationale citing FDA labeling or guidelines

Approval details:

Initial approval: typically 6 months. Renewal: 12 months with documented clinical response.

Payers Covering Aimovig

RxCheckUp tailors each LMN to the specific payer's medical policy and step therapy requirements:

UnitedHealthcareAetnaCignaBCBSExpress Scripts

Aimovig Prior Authorization FAQ

Why was my Aimovig prior authorization denied?

The most common denial reasons for Aimovig are: Headache diary missing; Two preventive trials not documented; Migraine days not specified.

What should a Aimovig Letter of Medical Necessity include?

Document migraine days per month, MIDAS or HIT-6 score, prior preventive trials with duration and outcomes, and the AHS criteria supporting CGRP therapy.

Which payers cover Aimovig?

Aimovig is covered by major US payers including UnitedHealthcare, Aetna, Cigna, BCBS, Express Scripts, though formulary tier and prior authorization criteria vary.

Prior Authorization Guides