Prices for New Migraine Treatments for 2018

An illustration of a man
suffering from a migraine.

Sebastian
Kaulitzki/Shutterstock

• Since May, the FDA has approved three new drugs in a new
  class of preventive migraine medication: Aimovig, made
  by Amgen and Novartis; Ajovy, made by Teva; and Emgality,
  made by Eli Lilly.
• Each one has a list price of $575 a month or $6,900 a year,
  with each drugmaker laying out its own approach to capturing the
  migraine market by offering the treatment for free.
• The market for these treatments is massive. An
  estimated 38 million Americans have
  migraines. Around
  a third of those people are
  eligible for these preventive treatments.

On Thursday,
the third in a new class of preventative migraine medications got
approved. 

The drug, Emgality, came out at the same list price as the other
two medications in the class — $575 per month, or $6,900 a year —
along with a plan to provide the drug for free to commercially
insured patients for up to a year. 

And it’s not the only drug to offer up huge discounts in the
first few months — and even years — of coming onto the market as
each drugmaker aims to capture the migraine market. 

Until 
May
,
there weren’t any drugs available today that were originally
approved for alleviating migraines, though other treatments —
including 
Botox
and anti-seizure medications
— have been used. Pain
relievers can also help treat some of the 
symptoms
of migraines
.

The new drugs, taken as monthly or quarterly injections,
aim to cut down on the number of migraine days patients
experience. 

The market for these treatments is massive. An
estimated 38 million American have migraines. Around
a third of those people are eligible for these preventive
treatments.

Here’s a breakdown of each drug’s approach to owning the market:

• Amgen and Novartis, Aimovig: $575 per
  month list price, two months of free samples, followed by
  a patient assistance program that provides up to a year of
  coverage if commercial insurance doesn’t cover it. For those
  with commercial insurance, there’s a $5 copay program that’s
  capped at $2,700 a year. 
• Teva, Ajovy: $575 per month list price,
  and a savings card that lets patients access Ajovy
  for free until December 2019.
• Lilly, Emgality: $575 per
  month list price, as well as starter kits in doctors’ offices.
  Lilly also plans to have a patient access program that provides
  up to 12 months of Emgality for free. 

In recent years, when competing drugs enter the market —
such as
treatments for hepatitis C — newcomers have undercut the list
price of medications. That’s not the case with the preventive
migraine treatments. 

“We believe the market for the next year will be very
contentious and net pricing could be substantially lower than the
$6,900 list price,” Wells Fargo analyst David Maris said in a
note Friday. There are still discounts drugmakers provide to
middlemen in the form of rebates, which will likely be a
competitive area for the three drugs. 

For example, Wei-Li Shao, the vice president of Lilly’s
neuroscience business told Business Insider that the company
is also in conversations with organizations responsible for
paying for medications, such as pharmacy benefit managers, to
strike up “value-based agreements” in which the drugmaker would
get paid for a medication based on how well it reduces migraines
in a particular patient.

For the drugmakers, providing the drug for free serves as a
way to get access to more patients at the upstart. Because the
treatments are preventative and migraines are a chronic
condition, the expectation is that patients will be on the
medication for a long enough time to make up for it, even if the
drugmakers aren’t making money off of it for months after it
comes on the market.

“We view this strategy as testament to the recognized
long-term size/value of this largely prevalent pool of patients
where we expect a significant degree of ‘stickiness’ once
patients are on treatment with a specific agent as opposed to
competing on price,” RBC Capital Markets analyst Kennen MacKay
said in a note Friday.  

Analysts expect
Aimovig alone to reach $1 billion in annual sales by 2022,
while Wells Fargo projected Ajovy to have $818 million in sales
by 2022.