What NYC Neurologists Should Know About 79th Street Pharmacy for CGRP & Migraine Patients
CGRP therapies transformed migraine treatment - but only for patients who can actually get and stay on them. In NYC, three obstacles routinely knock patients off therapy: prior authorization denials, retail pharmacies that don't stock the acute gepants, and $600+ copays when the manufacturer program was never applied.
This post outlines exactly how 79th Street Pharmacy operates for migraine and CGRP prescribers - what we stock, how we coordinate PA support with prescriber offices, how we resolve copay barriers, and how to refer a patient.
The Core Problem We Solve for Neurologists
The three most common reasons CGRP patients discontinue therapy after an initial script:
- Prior authorization denied for missing step-therapy documentation
- Acute gepants (Ubrelvy, Nurtec) not stocked at the patient's neighborhood pharmacy
- Sticker shock at the counter because no copay card was applied
We have built our workflow specifically to eliminate all three.
Inventory: Full CGRP Portfolio in Stock
Oral CGRPs (Gepants)
- Nurtec ODT (rimegepant) - 75 mg orally disintegrating tablets, both acute and preventive dosing
- Qulipta (atogepant) - 10 mg, 30 mg, 60 mg for episodic and chronic migraine prevention
- Ubrelvy (ubrogepant) - 50 mg, 100 mg for acute treatment
- Zavzpret (zavegepant) nasal spray - for acute treatment when oral is not tolerated
Injectable CGRP Monoclonal Antibodies
- Ajovy (fremanezumab) - 225 mg monthly and 675 mg quarterly autoinjector and prefilled syringe
- Emgality (galcanezumab) - 120 mg monthly, 100 mg cluster headache, and 240 mg loading dose
- Aimovig (erenumab) - 70 mg and 140 mg autoinjector
Infusion Referrals
- Vyepti (eptinezumab) - we coordinate with local infusion centers and handle the pharmacy-side benefit investigation
All injectables are stored in temperature-monitored medical-grade refrigeration at 36-46°F with continuous logging available on request.
Prior Authorization: We Coordinate With Prescriber Offices
CGRP PAs are the single biggest reason patients don't start therapy in the first place. Nearly every commercial and Medicare Part D plan requires step-therapy documentation - failure of two or more preventive classes (beta blockers, tricyclics, topiramate, Botox) and a headache diary showing 4+ migraine days per month.
What we do on your behalf:
- Pull the patient's fill history from our system and neighboring pharmacies to document prior preventive trials
- Send your office a pre-populated PA form with our findings so you can add clinical notes and submit
- Support the electronic PA submission through your office via CoverMyMeds or the plan's portal - not by fax
- Track the PA and support appeals with peer-to-peer scheduling coordination
- For step-therapy exceptions, draft the exception letter citing intolerance or contraindication for your review
When we coordinate PA submissions with prescriber offices, first-submission approval rates are above 80%, and above 95% after one appeal.
Copay & Cost: We Apply Every Program Automatically
Manufacturer Savings Programs We Apply
- Nurtec / Zavzpret Savings Card (Pfizer) - $0 for eligible commercial patients, up to $1,200/year
- Qulipta Complete Savings (AbbVie) - $0 for eligible commercial patients
- Ubrelvy Savings Card (AbbVie) - $0 for eligible commercial patients
- Ajovy Co-Pay Savings (Teva) - $5/month for eligible commercial patients
- Emgality Journey Savings (Lilly) - $0 for eligible commercial patients, up to $3,900/year
- Aimovig Ally (Amgen/Novartis) - $5/month for eligible commercial patients
We enroll every eligible patient at the point of dispensing - they do not need to have found the card themselves.
Patient Assistance for Uninsured / Underinsured
For uninsured patients or those with high-deductible plans, we submit applications to the manufacturer PAP programs (Amgen SafetyNet, Lilly Cares, AbbVie myAbbVie Assist, Pfizer RxPathways) and provide bridge supplies where possible during the approval window.
Medicare Part D Patients
Manufacturer copay cards are not available to Medicare beneficiaries under federal anti-kickback rules. For these patients we run the Extra Help / LIS eligibility check and coordinate with the HealthWell Foundation and Patient Advocate Foundation for grant funding where migraine-specific pools are open.
Delivery: Same Day Across NYC and NJ
For patients in the middle of an active migraine, waiting three days for a mail-order Ubrelvy shipment is not an option. Our delivery protocol:
- Free same-day delivery across all five boroughs and New Jersey (order by 2pm)
- Rush delivery within 2-4 hours available for acute rescue prescriptions
- Injectable CGRP mAbs delivered in temperature-controlled medical packaging - 36-46°F maintained end to end
- Discreet packaging, direct-to-patient with signature confirmation
Pharmacist Support: Injection Training and Adherence
First-time autoinjector patients (Ajovy, Emgality, Aimovig) often abandon therapy after one missed or painful injection. Our pharmacists provide:
- In-person or telephone injection training before the first dose
- Site rotation counseling and injection technique review at each refill
- Headache diary tools and monthly check-ins for the first three months of preventive therapy
- Escalation to your office for breakthrough migraines, unexpected side effects, or Botox coordination questions
How to Refer a Migraine Patient
- Send the prescription electronically to 79th Street Pharmacy (all major e-prescribing platforms)
- For preventive CGRP mAbs, include recent headache days per month and prior preventive failures in the sig or attached note - we use this to support the PA your office submits
- We contact the patient within 2 business hours to run benefits, apply savings, and coordinate delivery
- PA submitted by your office same day; medication dispensed the day the PA is approved
Related Resources
Contact and Referral Information
79th Street Pharmacy
215 W 79th Street, New York, NY 10024
(between Broadway and Amsterdam Avenue)
Phone: (646) 370-5978
Hours: Mon-Fri 9am-6pm | Sat 10am-3pm
Prescriber calls are prioritized - you will reach a pharmacist, not a technician, within minutes.