By Michelle Gerlovin, PharmD.
It looks like 2020 will be a big year for migraine sufferers. In the fall of 2019, the FDA approved Eli Lilly’s Reyvow for the acute (immediate) treatment of migraines. This is the first FDA-approved drug in a new class of acute migraine treatments that is taken orally as needed when a migraine occurs.
In late December, the FDA also approved Allergan’s Ubrelvy tablets for the acute treatment of migraine. Ubrelvy is another first-in-class drug that promises to help migraine sufferers find relief when a migraine occurs and works differently than Reyvow.
We are also expecting another competitor product sometime in the first half of 2020 called Rimegepant from Biohaven, which may be approved for both migraine prevention and acute treatment.
While the availability of several treatment options is great for migraine sufferers, payers and plan sponsors may be left wondering how these new drugs will impact their pharmacy spend. Reyvow is priced at $96 per tablet and Ubrelvy is $85 per tablet, but the dosing of these drugs will really impact the costs. Reyvow is limited to 1 tablet every 24-hours and Ubrelvy may require a second dose 2 hours after the initial dose.
It is also important to note that other existing treatments for migraine are available as generics and come with a much lower price tag. For example, generic Imitrex is available for less than $5 per tablet. We expect most PBMs will offer step therapy programs, quantity limits per month and other migraine management cost-containment solutions due to the high cost of these newer products and the availability of lower cost alternatives that may be clinically equivalent.
Truveris can help review your PBM’s clinical solutions and provide guidance on what is appropriate for your pharmacy benefit plan.