![]() ![]() According to one study, the number needed to treat would appear to be around four or five, so slightly better than Aimovig. At this point in time, there is less data on oral prophylaxis agents, such as Nurtec ODT. Multiple “number needed to treat” analyses show that every fifth or sixth patient taking Aimovig will benefit from this medication. For the monoclonal antibody CGRP antagonists, there is a mounting body of evidence of their effectiveness, as indicated in the ICER study and elsewhere. Payers will then review data on comparative effectiveness of both acute and preventive treatments for different sub-populations. To limit what they may deem to be undue financial exposure, payers will stratify migraine patients into categories, including types of headaches and frequency, as well as non-responders versus responders to traditional, cheaper medications, like triptans. Payers are a key arbiter determining patient access to new treatment options. The Institute for Clinical and Economic Review (ICER) performed an analysis of CGRP inhibitors and found that, overall, migraine patients had greater reductions in headache days per month compared to the use of other preventive medications.įor certain patients for whom triptans are not effective, not tolerated, or are contraindicated, Nurtec ODT and Ubrelvy as acute migraine treatment agents are considered by ICER to be comparatively cost-effective. The costs of novel migraine treatments are considerably higher than generic triptans and most other migraine therapies (including anti-hypertensives, anti-seizure medications, and anti-depressants), with the exception of Botox. With new, more expensive treatment options, however, come reimbursement challenges. Reyvow belongs to a class of drugs known as ditans. Additionally, there are now three oral CGRP antagonists (two of which have preventive properties), and Reyvow (lasmiditan), an oral medication used for the acute treatment of migraine. Vyepti is a once-every-three-months, healthcare provider-administered drug. The first three are once-a-month subcutaneous, self-administered injections. All four were launched as migraine preventive treatments. This includes four CGRP-targeting monoclonal antibodies – Aimovig (erenumab), Emgality (galcanezumab), Ajovy (fremanezumab), and Vyepti (eptinezumab). However, at least a third of patients do not respond well to triptans, and for many responders they lose efficacy over time.Īddressing this unmet need, 8 migraine treatments have been approved by the FDA since 2018. The most common treatments for acute migraine include the triptan (selective 5-hydroxytryptamine serotonin receptor agonist) class of medicines. ![]()
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