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Savings & Support

Lee H.
Actual Nurtec ODT patient.

*Per IQVIA as oral brand in class (oral CGRP receptor antagonists): number one prescribed and number one in new prescriptions, since 8/6/21. Data current as of 8/21/23.

Nurtec® OneSource: one stop for resources and
personalized patient support

Help give your patients access to the only migraine medication that treats and prevents all in one with our dedicated savings and support program.1,2 Call 1-833-4NURTEC for support with any of the following:

ACCESS FOR YOUR COMMERCIALLY INSURED PATIENTS

Eligible, commercially insured patients may pay as little as $0 per month with the Nurtec ODT copay card

Eligible commercially insured patients can, for one time only, access Nurtec ODT at no cost while benefits are being verified for as many as two prescription fills, with a combined maximum of 24 tablets total. Insurance coverage must be approved by the payor for patients to continue receiving Nurtec ODT with no out-of-pocket cost. No membership fees. Only available for commercially insured patients. This is not health insurance. The full terms and conditions can be accessed at nurtec.com/copay-terms.

SUPPORT FOR ALL PATIENTS

Assistance with the prior authorization process

SMS-based refill reminders

Hassle-free home delivery to patients

How to prescribe
Nurtec® ODT (rimegepant) 75 mg

Nurtec ODT 75 mg is available in blister packs of 8 tablets each. For preventive treatment, prescribe two 8-packs (16 tablets) per month. For acute treatment, you can prescribe one 8-pack, or double up to two 8-packs in one monthly prescription.1,*

1

In your EMR, simply select:

ASPN Pharmacies, LLC

290 West Mount Pleasant Ave, Livingston, NJ 07039 NPI: 1538590690 Prescriptions can also be faxed to ASPN Pharmacies at 1-877-371-2213.

A

or

Your local pharmacy

(for prescriptions not serviced through Nurtec® OneSource)

B

Don’t see ASPN Pharmacies in your ePrescribe platform? 

Select ASPN Pharmacy in your EMR mail order pharmacy option or check with your IT support for the last system update. If additional assistance is needed, please contact your EMR provider.

2

Select ICD-10-CM code:

The codes listed below may be appropriate to include with your request for your patient with migraine. Please refer to an ICD-10-CM resource for additional codes that may be applicable to your patient.

ICD-10-CM code and description

  • G43, Migraine 
  • G43.0, Migraine without aura 
  • G43.1, Migraine with aura
  • G43.9, Migraine, unspecified

3

Select quantity:

1 blister pack (8 tablets)
NDC: 72618-3000-02

A

or

2 blister packs (16 tablets)
NDC: 72618-3000-02

B

Include directions for use as appropriate

ACUTE: Take one tablet by mouth daily as needed for migraine. No more than one dose in 24 hours.
PREVENTIVE: Take one tablet by mouth every other day. No more than one dose in 24 hours.

Have questions for a Support Specialist?

Call 1-833-4NURTEC (1-833-468-7832) Monday through Friday from 8:30 am to 8:00 pm EST.

*The maximum dose of Nurtec ODT in a 24-hour period is 75 mg. The safety of using more than 18 doses of Nurtec ODT in a 30-day period has not been established.1
Codes are provided for informational purposes only. List may not be comprehensive. The healthcare provider is responsible for determining appropriate coding for treatment of their patients. Codes are not intended to encourage or suggest a use that is inconsistent with FDA-approved uses.

Nurtec ODT access support and copay card

If patients are not utilizing Nurtec® OneSource, other options are available to help with prior authorization and affordability. 

PRIOR AUTHORIZATION

Prior authorization assistance available through


1-866-452-5017

NURTEC ODT COPAY CARD

Eligible patients with commercial insurance may pay as little as $0 per month*

Let your eligible patients know they can download and activate a card today by visiting nurtec.com/savings

*Eligible commercially insured patients can, for one time only, access Nurtec ODT at no cost while benefits are being verified for as many as two prescription fills, with a combined maximum of 24 tablets total. Insurance coverage must be approved by the payor for patients to continue receiving Nurtec ODT with no out-of-pocket cost. No membership fees. Only available for commercially insured patients. This is not health insurance. The full terms and conditions can be accessed at nurtec.com/copay-terms.

More than 296 million individuals have access to Nurtec ODT across all channels*

With coverage for 96% of commercially insured lives*

Find specific formulary coverage in your area:

Auto-locate

OR

*Per Managed Markets Insights & Technology LLC as of 12/04/23.

Most insurance plans cover a monthly prescription 
for two 8-packs of Nurtec ODT (16 tablets) 
for acute treatment of migraine*

The maximum dose of Nurtec ODT in a 24-hour period is 75 mg. The safety of using more than 18 doses of Nurtec ODT in a 
30-day period has not been established.1

SELECT NATIONAL PLANS WITH 16-TABLET COVERAGE FOR ACUTE TREATMENT

PHARMACY BENEFIT MANAGERPLAN STATUSACUTE QL
CVSPreferred16
AETNAPreferred16
MEDIMPACTPreferred16
BLUE CROSS 
BLUE SHIELD FEPCovered18

FEP=Federal Employee Program; QL=quantity limit
*Per Managed Markets Insights and Technology LLC as of 8/11/23.
Majority of plans require Prior Authorization. While Pfizer strives to make this information as timely and accurate as possible, it makes no claims, promises or guarantees about the accuracy, completeness, or adequacy of the contents, and expressly disclaims liability for errors and omissions in the contents. Pfizer does not guarantee coverage of insured benefits; all benefits are subject to the insured’s plan requirements. Please consult the health plan directly for comprehensive policy information. Reference in this information to any specific payor plan does not constitute endorsement, recommendation or favoring by Pfizer and inclusion in a medical policy does not imply comparable or superior efficacy/safety of drug products.
Acute quantity limit is 56 tablets per 90-day prescription.

References: 1. Nurtec ODT. Package insert. Pfizer Inc. 2. Croop R, Lipton RB, Kudrow D, et al. Oral rimegepant for preventive treatment of migraine: a phase 2/3, randomised, double-blind, placebo-controlled trial. Lancet. 2020;397(10268): 51-60. doi:10.1016/S0140-6736(20)32544-7.