However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. Do not take UBRELVY if you are taking medicines known as strong CYP3A4 inhibitors, such as ketoconazole, clarithromycin, or itraconazole, or if you are allergic to UBRELVY or any of its ingredients. But, a low Ubrelvy dose (50 mg) is typically prescribed in these cases. MondayFriday, 8:00 am to 8:00 pm Eastern Time. Depending on the type of CYP3A4 inhibitor you take, you may or may not be able to take Ubrelvy. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. Learn why this happens and how to manage it, While most people experience a headache occasionally, migraine is a condition that causes severe head pain and other symptoms. For more information about Ubrelvys uses, see this article. When high doses of Ubrelvy were given to pregnant females in animal studies, the drug caused some harmful effects in the pregnant animals and their offspring. If you are having difficulty paying for your medicine, myAbbVie Assist may be able to help. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. And this can increase your risk for side effects from Ubrelvy. If you do not agree to the above, click NO to remain on UBRELVY.com. Most reactions happened within hours and were not serious. If you feel sleepy due to migraine attacks or after taking Ubrelvy, dont drive or use machinery until youve recovered. But weight loss can be a side effect of some drugs used to prevent migraine attacks, such as Topamax (topiramate). Also, some people temporarily lose their appetite during or after a migraine. UBRELVY [package insert]. So, taking Ubrelvy with this type of drug can cause Ubrelvy to break down faster in your body. In these studies, Ubrelvy also produced long-lasting pain relief for some people. Researchers are using advanced imaging techniques to learn more about the brains of people with migraine. Medicare offers a benefit that may help you, if you lose Part A coverage 36 months after a kidney transplant, and you don't have certain types of other health coverage (like a group health plan, TRICARE, or Medicaid that covers immunosuppressive drugs). If you do not agree to the above, click Cancel to remain on the current website. The lowest GoodRx price for the most common version of Nurtec is around $922.30, 13% off the average retail price of $1,065.64. Please see full Program Terms, Conditions, . The most common side effects were nausea (2-4%) and tiredness (2-3%). However, generic forms of Imitrex are available. Below are examples of medications that can interact with Ubrelvy. Ubrogepant (Ubrelvy) received FDA approval for the treatment of acute migraine in adults in December 2019, and rimegepant (Nurtec) received similar FDA approval in February 2020. The typical dosage of Ubrelvy is 50 mg or 100 mg. You should take a dose as soon as possible after migraine symptoms start. It depends on which coverage stage you are in. Do not use more Ubrelvy than your doctor recommends. For this reason, Ubrelvy may be a good option for people who have bothersome or severe side effects from triptans. Triptans are a class of drugs. It can also interact with certain supplements as well as certain foods. By clicking Continue below, you acknowledge and agree that AbbVie does not, in any way, endorse or recommend the American Migraine Foundation (AMF), a division of the American Headache Society, any healthcare provider (HCP), or the qualifications of any HCP associated with AMF, or the quality of medical care any of those HCPs can provide. You are encouraged to report negative side effects of prescription drugs to the FDA. Now, theyre sharing their migraine journeys with the world. Message and data rates may apply. This offer is valid for up to 13 prescription fills. See the end of the Medication Guide for a complete list of ingredients in UBRELVY. By redeeming this offer, you acknowledge that you are an eligible commercially insured patient and that you understand and agree to comply with the above terms and conditions. Ubrelvy is a brand-name prescription medication. This article provides several useful tips on medication disposal. These are not all of the possible side effects of UBRELVY. Ubrelvy 100mg 10 tablets at Walgreens $1,184 $ 1,023 Save 14% BIN PCN Group Member ID 015995 GDC DR33 DHF954688 Coupon Last updated May 1 The most common side effects of UBRELVY are nausea (4%) and sleepiness (3%). No. This offer is not valid for cash-paying patients. Message frequency depends on user. Off-label drug use means using a drug for a purpose other than what its been approved for by the FDA. For questions, call UpScript, one of many telemedicine platforms, lets you speak with a healthcare provider to see if UBRELVY is right for you, all from the comfort of your own home. For instance, some interactions can interfere with how well a drug works. It was the first oral (taken by mouth) CGRP antagonist approved for the acute treatment of migraine. Please see full Program Terms, Conditions, and Eligibility Criteria. (A generic drug is an exact copy of the active drug in a brand-name medication. This offer is valid only for patients 18 years of age or older and is good for use only with a valid prescription for UBRELVY (ubrogepant) tablets at the time the prescription is filled by the pharmacist and dispensed to the patient. Note: Ubrelvy isnt meant to be taken every day. Please see accompanying Patient Information or visit, Reference: 1. It is intended for people that live in the United States, have limited or no health insurance coverage and demonstrate qualifying financial need. Yes. Other ways to save on Ubrelvy Part A (Hospital Insurance) may help cover your care and services when you are formally admitted into a Medicare-approved hospital. When you get Ubrelvy from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. However, be sure to take the dosage your doctor prescribes for you. This prevents CGRP from producing its effects in the brain, which can relieve migraine symptoms. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. You are encouraged to report negative side effects of prescription drugs to the FDA. Ubrelvy may be available through a mail-order pharmacy. Eligible commercially insured patients/RX not covered may pay $0 for a maximum of 4 monthly fills; for additional information contact the program at 844-577-6239. Vasoconstriction can also lead to serious side effects, including a heart attack, very high blood pressure, or reduced blood flow to your intestines. Behind every migraine journey, theres a story. Sleepiness. You can also ask your pharmacist for information about how to dispose of your medication. This is because Ubrelvy has a half-life of about 5 to 7 hours. Your type of health or prescription insurance plan will determine exactly how much you will pay. Heres some detail on certain side effects this drug may or may not cause. UBRELVY is not used to prevent migraine headaches. There are two ways to get your U-Save Card: Patient out-of-pocket costs may vary. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. All rights reserved. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. UpScript, one of many telemedicine platforms, lets you speak with a healthcare provider to see if UBRELVY is right for you, all from the comfort of your own home. Most people have relief from their migraine symptoms within 2 hours after taking a dose. The actual price youll pay for either drug depends on your insurance plan, your location, and the pharmacy you use. This can help you identify patterns in what might trigger them. Ubrelvy may interact with certain herbs and supplements, which are described below. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms. Ubrelvy should not be taken with medications that are strong CYP3A4 inhibitors. Medicare Drug List For insurance through your employer Search the list of drugs covered under your insurance plan through your employer by using our search tool or printing out the full list. Visitwww.fda.gov/medwatch or call 1-800-FDA-1088. If you have questions about this, talk with your doctor. During a migraine, levels of a protein called calcitonin gene-receptor related peptide (CGRP) increase in your brain. If you take Ubrelvy with grapefruit, Ubrelvy can build up in your body. *Patient out-of-pocket costs may vary. 90245 . If youre interested in learning more about rimegepant, talk with your doctor. It is wholly and solely your responsibility to assess the qualifications of a potential physician. child who is breastfeeding. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. PROGRAM TERMS, CONDITIONS, AND ELIGIBILITY CRITERIA: For questions about the program, including savings on mail-order prescriptions, or to activate your card ID, please call 1-844-577-6239. Message frequency depends on user. Controlled substances also have a high risk of causing dependence. If you are having difficulty paying for your medicine, AbbVie may be able to help. AbbVie recommends that you meet and discuss the benefits and risks of all potential treatments with the potential physician. And this can lower the amount of Ubrelvy in your body and make the drug less effective. Its not known if its safe to take the drug more often than this. Its not known if Ubrelvy is safe to take during pregnancy. Terms and Conditions apply. By clicking Talk Now below, you acknowledge and agree that AbbVie does not, in any way, endorse or recommend the qualifications of any physician associated with the third-party website, or the quality of medical care any of those physicians can provide. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it. About one-third of people with migraine also have an aura before or during the headache. If you take St. Johns wort, Ubrelvy is not usually recommended for you. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. If youre breastfeeding or if you plan to breastfeed, talk with your doctor before taking Ubrelvy. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Used for acute treatment of migraine See below for examples of CYP3A4 inhibitors and details. These are not all of the possible side effects of UBRELVY. And, talk with your doctor about other activities you may need to avoid after taking Ubrelvy. The cause of tension headache isnt fully understood. AbbVie reserves the right to rescind, revoke, or amend this offer without notice. Applies to: Ubrelvy Number of uses: 4 times. It works to block CGRP receptors in your brain. You are encouraged to report negative side effects of prescription drugs to the FDA. But, a low Ubrelvy dose (50 mg) is typically prescribed in these cases. ABBVIE AND ITS AFFILIATES HEREBY DISCLAIM ANY LIABILITY ARISING FROM YOUR USE AND/OR RELIANCE ON THE INFORMATION CONTAINED ON THE AMF WEBSITE. It can also cause pain, pressure, or tightness that affects your chest, throat, neck, or jaw. Consent not required to purchase goods/services. If you have nausea thats bothersome or severe while taking Ubrelvy, talk with your doctor about ways to manage this side effect. Instead, Ubrelvy belongs to a class of drugs called oral calcitonin gene-receptor peptide (CGRP) antagonists. For Medicare Search the list of drugs covered under your Medicare plan by using our search tool or printing out the full list. If you have trouble swallowing Ubrelvy tablets, talk with your doctor. There arent currently any treatments that can cure migraine. If this side effect bothers you, talk with your doctor. Examples of questions you may want to ask your doctor or insurance provider include: To learn more about migraine symptoms and the latest treatments, sign up for Healthlines online newsletter. The maximum dose of Ubrelvy is 200 mg in 24 hours. Generics tend to cost less than brand-name drugs. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. In animal studies, Ubrelvy did pass into breast milk. In addition to the use listed above, Ubrelvy may also be used off-label for other conditions. Ubrelvy comes as a tablet you swallow and contains the active ingredient ubrogepant. What are the ingredients in UBRELVY? CYP3A4 inducer medications increase the activity of this enzyme. Terms and Conditions apply. Neither drug is used to prevent migraine or cluster headaches. Some people also have trouble speaking. No, Ubrelvy cant cure migraine. Terms and Conditions apply. Weight loss wasnt reported in clinical studies of Ubrelvy. Subject to all other terms and conditions, a commercially insured patient whose plan covers UBRELVY will pay $0 for their first one-month prescription fill of UBRELVY per calendar year, and . But, theyre not used to prevent migraine attacks. Active ingredient:ubrogepant Madison, NJ: Allergan USA, Inc. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you receive care for a migraine while in an emergency room or urgent care facility, these charges may fall under allowable coverage for Medicare Part A and Part B. *Patient out-of-pocket costs will vary. If at any time, a participating patient begins receiving prescription drug coverage under any federal, state, or government-funded healthcare program, the patient will no longer be eligible for the UBRELVY U-Save Savings Program and must cease participation. Other drugs are available that can be used for acute (immediate) treatment of migraine. This novel blood clot treatment doesn't increase bleeding risk, Why young women have more adverse outcomes after a heart attack than young men, Gut microbiome appears to fluctuate throughout the day and across seasons, One-hour endoscopic procedure could eliminate the need for insulin for type 2 diabetes, New clues to slow aging? Visit www.fda.gov/medwatch or call 1-800-FDA-1088. The expiration date helps guarantee that the medication is effective during this time. Dancing with the Stars champion and judge Derek Hough has created simple, easy-to-follow movement routines that may help prevent headaches and reduce. Order Online > *This offer is not valid for patients enrolled in Medicare, Medicaid, or other state or . If you need financial support to pay for Ubrelvy, or if you need help understanding your insurance coverage, help is available. Here are resources to help find care if you, Stressed? This can cause mild symptoms, such as numbness, tingling sensations, or feeling hot or cold. Ubrelvy is a type of drug called an oral CGRP antagonist. It is wholly and solely your responsibility to assess the qualifications of a potential physician. It works by blocking CGRP from attaching to its receptors. Before taking Ubrelvy, talk with your doctor about your health history. As long as your doctor approves, you may take a second dose of Ubrelvy as needed. It was approved in 2019 for acute (immediate) treatment of migraine that occurs with or without aura. Message frequency depends on user. Weight loss isnt a known side effect of any drugs used to treat migraine. But animal studies dont always predict what will happen in humans. Different interactions can cause different effects. Visit the SingleCare website or app to compare the lowest cost of Ubrelvy with SingleCare versus your price with insurance or Medicare. Generics usually cost less than brand-name drugs. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. If you agree to the above, click YES to proceed to the third-party website. Here's how: Answer a few simple questions about your migraine attacks and current treatment plan. This offer is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs) or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Offer good only in the USA, including Puerto Rico, at participating retail pharmacies. MIGRAINE MEDICINETM. Do not take UBRELVY if you are taking medicines known as strong CYP3A4 inhibitors, such as ketoconazole, clarithromycin, itraconazole. Visitwww.fda.gov/medwatch or call 1-800-FDA-1088. A fee is charged by UpScript. As with most drugs, some people can have an allergic reaction after taking Ubrelvy. Grapefruit inhibits CYP3A4, meaning that it stops the enzyme from working as well as usual. It was approved last year to treat episodic migraine. By clicking Yes below, you acknowledge and agree that Allergan does not, in any way, endorse or recommend the qualifications of any physician associated with the third-party website, or the quality of medical care any of those physicians can provide. In 2020, another oral CGRP antagonist was also approved for acute migraine treatment. This offer is only valid for commercially insured patients. If you take a moderate CYP3A4 inhibitor, you shouldnt take a second dose of Ubrelvy within 24 hours of your first dose. This offer is only valid for commercially insured patients. By redeeming this offer, you acknowledge that you are an eligible commercially insured patient and that you understand and agree to comply with the above terms and conditions. Patients may not use this card if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, calcitonin gene-related peptide (CGRP) antagonists, calcitonin gene-receptor peptide (CGRP) antagonists, calcitonin gene-receptor related peptide (CGRP), Ubrelvy expiration, storage, and disposal, A safer blood thinner? You are encouraged to report negative side effects of prescription drugs to the FDA. If your insurance plan has a different copay structure, or if you dont have insurance, the strength may affect the price. Ubrelvy is approved for the acute (immediate) treatment of migraine. Learn about these and 14 other common migraine triggers. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. If you need help covering the cost of Ubrelvy or understanding your insurance, check out these websites: On these sites, you can find insurance information, details on copay assistance programs, and links to savings cards and other services. If you are having difficulty paying for your medicine, AbbVie may be able to help. This offer is not valid for cash-paying patients. What is UBRELVY(ubrogepant)? You are encouraged to report negative side effects of prescription drugs to the FDA. Patients may not use this card if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our. The manufacturer of a brand-name drug can sell the drug for up to 20 years. In comparison, 1% of people who took a placebo had these side effects. However, Ubrelvy is not used to prevent migraine. To learn about AbbVies privacy practices and your privacy choices, visit https://privacy.abbvie. You are encouraged to report negative side effects of prescription drugs to the FDA. Researchers looked at the percentage of people who had relief from their migraine symptoms 2 hours after taking a dose. Please see full Program Terms, Conditions, and Eligibility Criteria. What is the difference between a headache and migraine? Before taking UBRELVY, tell your healthcare provider about all your medical conditions, including if you: Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. A neurologist can provide expert assessment, diagnosis, and treatment for migraine. If you have questions about what kind of drug Ubrelvy is or how it works, talk with your doctor or pharmacist. Message and data rates may apply. This offer is only valid for commercially insured patients. After Ubrelvy became available for use, allergic reaction was reported by some people minutes, hours, or days after taking the drug. US-UBR-230012 February 2023, FOR RECENT UPDATE TO IMPORTANT SAFETY INFORMATION. This article does not contain all drugs that may interact with Ubrelvy. By clicking Talk Now below, you acknowledge and agree that AbbVie does not, in any way, endorse or recommend the qualifications of any physician associated with the third-party website, or the quality of medical care any of those physicians can provide. As with all medications, the cost of Ubrelvy can vary. The cost of Ubrelvy that is covered by insurance can also be affected by factors such as: your days' supply of medication (30 days versus 90 days) which pharmacy you use your treatment plan To. Having any of these symptoms may be referred to as having a migraine attack or migraine episode. The following lists contain some of the key side effects that may occur while taking Ubrelvy. This site is intended for U.S. consumers only. These are not all of the possible side effects of UBRELVY. 1.844.4.UBRELVY (1.844.482.7358), of UBRELVY are nausea (4%) and sleepiness (3%). This helps prevent others, including children and pets, from taking the drug by accident. If youre interested in this option, check with your doctor and your insurance company. This describes the drugs effect on the CYP3A4 enzyme. 68% of Medicare prescription drug plans cover this drug. The first in a different class of migraine treatments, Migrain pain relief starts with U - Video play. The following describes the recent changes to the UBRELVY Patient Information: The following serious allergic reactions information was added: What are the possible side effects of UBRELVY? Ubrelvy has been effective for acute treatment of migraine in clinical studies. With a Medicare Advantage (Medicare Part C) plan that includes prescription drug coverage In 2022, 89% of Medicare Advantage plans include prescription drug coverage. Initial Authorization . Ubrelvy U-Save Card. Before a migraine attack, some people may have sensory changes known as an aura. You shouldnt take Ubrelvy to treat more than 8 migraine attacks per month (30 days). Ubrelvy is not usually recommended for use with strong CYP3A4 inducers. Call 911 or your local emergency number if your symptoms feel life threatening or if you think youre having a medical emergency. Message and data rates apply. . To learn more about how health insurance works, click here. This article focuses on Ubrelvy, not rimegepant. UBRELVY is not used to prevent migraine headaches. *Patient out-of-pocket costs may vary. Fill out and bring this conversation starter to discuss what's working or not working with your current treatment plan. Your healthcare provider can tell you if it is safe to take UBRELVY with other medicines. If you have migraines more than 4 times per month, talk with your doctor about ways to help prevent them. Many people use magnesium, which is a naturally occurring mineral, to treat and prevent migraine headaches, especially those with aura. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. The way a drug works is called its mechanism of action. Controlled substances are drugs that have a high potential for being misused, usually because they can make people feel high. Misuse is taking a drug in a way other than how a doctor prescribes it. Tennis superstar Serena Williams and gold medal-winning gymnast Aly Raisman battled migraine pain for years before they found relief with UBREVLY. It typically takes about five half-lives for a drug to no longer have any effect in your body. MondayFriday, 8:00 am to 8:00 pm Eastern Time. If my Medicare prescription drug plan covers Ubrelvy, how much will I pay? Ubrelvy (ubrogepant) tablets, for oral use. Ubrelvy may also be useful for people who cant take triptans, such as people with heart disease or hemiplegic migraines. Yes. If a prescription is written, you can pick it up at a local pharmacy you choose. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. To read more about Ubrelvys mechanism of action, see the How Ubrelvy works section below. Talk with your doctor about migraine treatment options other than Ubrelvy. You are encouraged to report negative side effects of prescription drugs to the FDA. But if you have health insurance, youll need to talk with your insurance provider to learn the actual cost youll pay. Ubrelvy and Imitrex belong to different drug classes. CGRP is released from your trigeminal nerve. If you have questions, want to update your information, or terminate your enrollment, please call 1-800-222-6885 or write to us at A Prescription Drug List (PDL) - also called a formulary - is a list of commonly used medications, organized into cost levels, called tiers. MNT is the registered trade mark of Healthline Media. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Ubrelvy is approved for acute (immediate) treatment of migraine in adults. Patients residing in or receiving treatment in certain states may not be eligible to participate in this program. CGRP has several effects that help produce the symptoms of a migraine: CGRP produces these effects by attaching to sites called CGRP receptors. Commercially insured patients whose plans require a prior authorization or do not cover UBRELVY cannot apply savings received from the UBRELVY U-Save Savings Program toward any out- of-pocket limits or other deductibles under their insurance coverage, Patients may not seek reimbursement for value received from the UBRELVY U-Save Savings Program from any third-party payers. Keeping track of your migraine symptoms can help you and your doctor see how well Ubrelvy works for you. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. They may recommend taking antinausea medication. The price you pay for Ubrelvy can vary. Allergic reactions. This page provides information that can help you determine how much UBRELVY may cost for you, as well as financial support programs that may be able to help you afford your medication. Below are examples of these side effects. If youre pregnant or planning to become pregnant, talk with your doctor before taking Ubrelvy. Do not take UBRELVY if you are taking medicines known as strong CYP3A4 inhibitors, such as ketoconazole, clarithromycin, itraconazole. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. ALLERGAN AND ITS RESPECTIVE AFFILIATES HEREBY DISCLAIM ANY LIABILITY ARISING FROM YOUR USE AND/OR RELIANCE ON THE INFORMATION CONTAINED ON THE THIRD-PARTY WEBSITE. In some cases, it can quickly provide complete relief from migraine symptoms. Nausea is the most common side effect reported in clinical studies of Ubrelvy. Prescription 100mg Ubrelvy (10 tablets) edit Choose your pharmacy Near boydton, VA Walgreens Harris Teeter Food Lion Kroger 2 more. UBRELVY is a prescription medicine used for the acute treatment of migraine attacks with or without aura in adults. You may feel tired or sleepy while taking Ubrelvy. Tell them about all prescription, over-the-counter, and other drugs you take. But, a high Ubrelvy dose (100 mg) is typically prescribed in these cases. The Ubrelvy dosage your doctor prescribes will depend on several factors. For this reason, its not known if Ubrelvy passes into breast milk or whether it may affect a child who is breastfeeding. Symptoms of a severe allergic reaction can include: Call your doctor right away if you have an allergic reaction to Ubrelvy, as the reaction could become severe. The drug hasnt been studied in people who are breastfeeding. There are two ways to get your U-Save Card: Patient out-of-pocket costs will vary. In comparison, 8.2% to 8.6% of people who had no migraine pain 2 hours after taking a placebo also had no migraine pain up to 24 hours later. If you do not agree to the above, click BACK TO SITE to remain on UBRELVY.com. Ubrelvy comes as a tablet thats taken by mouth when migraine symptoms start to occur. Reply HELP for help; reply STOP to cancel. And because generics have the same ingredients as brand-name drugs, they dont need to be studied again. (A placebo is a treatment with no active drug.) Based on retail and nonretail monthly prescription data from IQVIA on a 6-month rolling basis as of 09/22. If you no longer need to take Ubrelvy and have leftover medication, its important to dispose of it safely. Ubrelvy is not approved for use in children. 2023 Healthline Media UK Ltd, Brighton, UK. Sharing this information can help you avoid potential interactions.
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is ubrelvy covered by medicare