Clash of three migraines medications & cost benefit for patients

By Ajay V. Patil

With the eligible patient pool of about 15 million, three migraine medications – Aimovig (Amgen), Ajovy (Teva), Emgality (Eli Lilly) fight for the market share with similar medical plans

Within short period of last 5 months, FDA approved three preventive drugs for alleviating migraines. This is very important considering the patient pool of about 36 million around the world, among which 15 million patients are expected to be eligible for these treatments. Before this, the commonly used treatments like botox and anti-seizure medications, pain relievers were used, just to treat some of the symptoms of migraines.

Here are those three approved medications,

1. Aimovig (Erenumab) from Amgen and Novartis is a fully human monoclonal antibody targeting calcitonin gene-related peptide receptor (CGRP-R) with 70 mg–140 mg once a month recommended dosage.
2. Ajovy (Fremanezumab) from Teva is also a monoclonal antibody targeting calcitonin gene-related peptide (CGRP), with two dosing options – 225 mg (monthly), or 675 mg (quarterly).
3. Emgality (Galcanezumab) from Eli Lilly is another humanized monoclonal antibody directed against CGRP with the dosage of 120 mg once a month.

All these products have $575 per month list price and patient assistance programs which could provide up to a year of free coverage for patients. The free coverage for a year is planned, keeping in mind the chronic nature and wider epidemiology of the disease. The expectation by the companies is that, patients will be on the medication enough time to make up for initial investment. This is not the first time that similar products employ such cost saving strategies to capture the market. We have recently seen the similar strategy being employed with 50% price cuts offered by both Keytruda and Opdivo in the Chinese market. Looking at the current scenario, prices of these preventive drugs for migraine are expected to be even more affordable from the next year.

Besides these three drugs, another similar candidate eptinezumab from Alder Biopharmaceuticals is also under development. Ultimately the drug with superior long standing performance will have a better market share.

References

1. https://www.businessinsider.com/prices-for-new-migraine-treatments-for-2018-2018-9
2. https://www.novartis.com/news/media-releases/novartis-and-amgen-announce-fda-approval-aimovigtm-erenumab-novel-treatment-developed-specifically-migraine-prevention
3. https://marketrealist.com/2018/09/competition-dynamics-for-ajovy-tevas-migraine-drug

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