This website is intended for US healthcare professionals only.
VYEPTI permanent J-code (J3032) is now available. Learn more
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Lundbeck is committed to patient access and providing support through a VYEPTI CONNECT liaison or a field reimbursement specialist. Below are resources that may be helpful.
Downloadable resources
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VYEPTI CONNECT Enrollment Form
Download the enrollment form and begin the benefits investigation process.
VYEPTI CONNECT Overview
Download information about VYEPTI CONNECT. This optional program offers access support throughout the treatment journey.
Physician Attestation
Physicians with patients who do not wish to enroll in VYEPTI CONNECT but still want access support from a Field Reimbursement Specialist should download and submit this form.
California Patient Attestation
Providers in California who have prescribed VYEPTI must have their patients fill out this form and submit it along with the VYEPTI CONNECT Enrollment Form.
How to Order VYEPTI Under the Medical Benefit
Information about the ordering and distribution of VYEPTI under the medical benefit.
Billing and Coding Guide
Information that may be helpful when submitting claims for VYEPTI.
Prior Authorization (PA) Checklist
Information that may help you organize material that may be needed to complete a PA for VYEPTI.
Sample Letter of Medical Necessity
Information about what may be needed to complete a Letter of Medical Necessity.
Sample Letter of Appeal
Information about what may be needed to complete a Letter of Appeal.
Sample Letter of Medical Exception
Information about what may be needed to complete a Letter of Medical Exception.
Site of Care Transition Form
Download and share with patients about their next site of care.
Specialty Pharmacy Checklist
Information on how to successfully submit all necessary information to a specialty pharmacy for a patient's prescription.
VYEPTI Copay Assistance Program Overview
Information on eligibility requirements and how your commercial patients can enroll in the program.
VYEPTI CONNECT Terms and Conditions
Review the Terms and Conditions for VYEPTI CONNECT support.
VYEPTI Copay Assistance Program Terms and Conditions
Review the Terms and Conditions for VYEPTI Copay Assistance Program.
The resources on this page are for informational purposes only and are not intended to provide reimbursement or legal advice. The information presented here does not guarantee payment or coverage.
IMPORTANT SAFETY INFORMATION
AND INDICATION
Contraindications
VYEPTI is contraindicated in patients with serious hypersensitivity to eptinezumab-jjmr or to any of the excipients. Reactions have included angioedema.
INDICATION
VYEPTI is indicated for the preventive treatment of migraine in adults.
Warnings and Precautions
Hypersensitivity reactions: Hypersensitivity reactions, including angioedema, urticaria, facial flushing, and rash, have occurred with VYEPTI in clinical trials. Most hypersensitivity reactions occurred during infusion and were not serious, but often led to discontinuation or required treatment. Serious hypersensitivity reactions may occur. If a hypersensitivity reaction occurs, consider discontinuing VYEPTI, and institute appropriate therapy.
Adverse Reactions
The most common adverse reactions (≥2% and at least 2% or greater than placebo) in the clinical trials for the preventive treatment of migraine were nasopharyngitis and hypersensitivity.
For more information, please see the Prescribing Information and Patient Information.
IMPORTANT SAFETY INFORMATION
AND INDICATION
Contraindications
VYEPTI is contraindicated in patients with serious hypersensitivity to eptinezumab-jjmr or to any of the excipients. Reactions have included angioedema.
INDICATION
VYEPTI is indicated for the preventive treatment of migraine in adults.
Warnings and Precautions
Hypersensitivity reactions: Hypersensitivity reactions, including angioedema, urticaria, facial flushing, and rash, have occurred with VYEPTI in clinical trials. Most hypersensitivity reactions occurred during infusion and were not serious, but often led to discontinuation or required treatment. Serious hypersensitivity reactions may occur. If a hypersensitivity reaction occurs, consider discontinuing VYEPTI, and institute appropriate therapy.
Adverse Reactions
The most common adverse reactions (≥2% and at least 2% or greater than placebo) in the clinical trials for the preventive treatment of migraine were nasopharyngitis and hypersensitivity.
For more information, please see the Prescribing Information and Patient Information.
© 2021 Lundbeck. All rights reserved. VYEPTI, VYEPTI CONNECT, and VYEPTI GO are registered trademarks of Lundbeck Seattle BioPharmaceuticals, Inc. EPT-B-100032v5
This website is intended for US healthcare professionals only.
