New migraine treatments offer options for patients

In the past week, the migraine prevention drug market has suddenly heated up, with 2 new approvals by FDA.

FDA approved galcanezumab-gnlm (Emgality, Eli Lilly and Company) 120 mg injection for the preventive treatment of migraine in adults, soon after giving the greenlight to  fremanezumab-vfrm (Ajovy, Teva)  injection, an anti calcitonin gene-related peptide receptor (CGRP-R) treatment for the prevention of migraine with quarterly and monthly dosing options.

Plus, erenumab-aooe (Aimovig, Amgen), was approved in May as the first anti-CGRP-R drug. Aimovig is self-administered once monthly via Amgen's device, the SureClick autoinjector. Similarly, Emgality is administered via a once-monthly, self-administered, subcutaneous injection.

Related: New migraine prevention drug faces competition

All 3 migraine drugs are also priced at around $600 monthly-and the cost to insured patients is often free.

The migraine prevention market is exploding now after pharma makers have been researching and developing anti CGRP-R treatments for 2 decades. In the 1990s, scientists discovered the role that CGRP plays in migraine, “Which spurred the research and development of the technology required to develop antibodies that could bind to CGRP and block its binding to the receptor,” Gudarz Davar, MD, vice president, neuroscience platform leader for Eli Lilly & Company, told FormularyWatch.

“Lilly has been committed to helping people living with headache disorders for more than 25 years, investigating more than a dozen different compounds, including Emgality, which was selected for clinical study…[in] 2009,” Davar said.

Related: Investigational drug appears beneficial in preventing migraines

"Despite the devastating impact of migraine, only about 10% of people living with the disease are currently taking a preventive treatment," added Christi Shaw, president of Lilly Bio-Medicines, in a statement from the company.

The price of Emgality is $575 per month, or $6,900 annually. Patients with commercial insurance are candidates to receive Emgality for up to 12 months free as part of Lilly’s patient support program.

Similarly, the Wholesale Acquisition Cost (WAC) of Ajovy is $575 per monthly dose and $1,725 per quarterly dose.

While Lilly supports the need for multiple treatment options for adults with migraine, Davar hopes that patients and physicians will choose Emgality. In Lilly’s trial, 1 in 7 patients with episodic migraine realized a 100% reduction in migraine headache days on average in any given month, he said.

The total unadjusted cost associated with migraine in the United States is estimated to be as high as $56 billion annually, yet it remains under-recognized and under-treated, Davar added.

Read more: Top 3 new drug approvals