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.

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VYEPTI CONNECT Enrollment Form

Complete this enrollment form to begin the benefits investigation process.

VYEPTI CONNECT Brochure

A program that offers access support throughout your patient’s treatment.

VYEPTI CONNECT Copay Assistance Program Overview

Information on how your eligible commercially insured patients can enroll and the program's eligibility requirements.

Copay Reimbursement Fax Cover Sheet

Use this cover sheet when submitting copay claims for reimbursement to the VYEPTI CONNECT Copay Assistance Program.

Billing and Coding Guide

Information that may be helpful when submitting claims for VYEPTI.

Distribution and Infusion Location Guide

Information about acquiring VYEPTI under the medical benefit and the settings where it can be infused.

VYEPTI Purchasing Process Overview

Information about acquiring VYEPTI through a Specialty Pharmacy and buy-and-bill.

Specialty Pharmacy Checklist

Information on how to successfully submit necessary information to a Specialty Pharmacy for a patient's prescription.

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 fill out patient information for transition to a new infusion location.

Healthcare Provider Attestation

Healthcare providers 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.

Field Reimbursement Specialist Patient Authorization

Healthcare providers in California 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 in addition to the Healthcare Provider Attestation; authorization can be sent via fax.

VYEPTI CONNECT Terms and Conditions

Review the Terms and Conditions for VYEPTI CONNECT.

VYEPTI CONNECT Copay Assistance Program Terms and Conditions

Review the Terms and Conditions for the VYEPTI CONNECT 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.

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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 anaphylaxis and 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. Cases of anaphylaxis have been reported in the postmarketing setting. 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 anaphylaxis and 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. Cases of anaphylaxis have been reported in the postmarketing setting. 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.