Ocrevus, Aimovig, Botox for migraine, and Spravato all require prior authorization. Payers frequently deny on step therapy grounds — requiring documented failure of older agents that cost a fraction of the price.
| Drug / Class | Common Denial Reason | PriorZap Prevention |
|---|---|---|
| Ocrevus (ocrelizumab) | No documented failure of first-line MS therapy | Prior therapy history auto-pulled from FHIR Rx record |
| Aimovig (erenumab) | Fewer than 4 migraine days/month documented | Migraine diary data captured from structured encounter notes |
| Botox for migraine | Not documented as chronic migraine (≥15 days/month) | Migraine frequency validated from visit notes at order entry |
| Spravato (esketamine) | Missing prior antidepressant failure documentation | MDD treatment history auto-captured from Rx history |
| Nurtec (rimegepant) | Step therapy — must try triptan first | Triptan trial documented or contraindication flagged |
| Tysabri (natalizumab) | JC virus antibody status not on file | JCV test order triggered automatically |
PriorZap embeds into your EHR at the point of prescribing, validates prior therapy documentation, and captures migraine frequency data before the authorization request leaves your office.