According to DRG epidemiology, more than 35 million people in the United States suffer from migraines. Despite being underutilized, migraine prophylaxis is a core treatment approach to reduce migraine frequency, severity, and duration. Prescription options include a diverse mix of on- and off-label oral drugs, newly launched anti-CGRP MAbs (i.e., Amgen / Novartis’s Aimovig, Teva’s Ajovy, and Eli Lilly’s Emgality), and Allergan’s Botox, which the FDA approved specifically for chronic migraine prevention. Prophylaxis is both individualized and dynamic, as physicians adjust regimens to improve outcomes and/or avoid side effects. Understanding this patient journey provides needed context for new and existing players as new preventives establish themselves in the market.


  • What patient shares do key therapies and brands garner by line of therapy in migraine patients initiating prophylaxis? What are the quarterly trends in prescribing recently treated and prophylactically naive migraine patients?
  • How have anti-CGRP MAbs been integrated into the treatment algorithm, and what claims did they capture by the end of our claims period?
  • What percentage of prophylactically naive migraine patients began drug therapy within our two-year prescription-tracking period? What percentage of patients progress to later lines of therapy, and how quickly do they progress?
  • What percentage of migraine patients are treated with monotherapy versus combination therapy? What are the most frequently used combinations?
  • What are the product-level compliance and persistency rates among prophylactically treated patients?

Geographies: United States

Real-World Data: Longitudinal patient-level claims data analysis

Key Drugs Covered: Aimovig, Ajovy, Emgality, Botox, Trokendi XR, Qudexy XR, topiramate IR/XR, propranolol, amitriptyline, verapamil, others

Key Analysis Provided:

  • Brand/therapy usage across longitudinal patient sample.
  • Prophylactically naive patient analysis.
  • Treatment initiation and progression.
  • Line of therapy analysis.
  • Combination therapy analysis.
  • Source of business for recently treated patients.
  • Persistency and compliance analysis.

Product Description

Treatment Algorithms: Claims Data Analysis provides detailed, quantitative analysis of the treatment journey and brand usage across lines of therapy and overall using real-world, patient-level claims data so that marketers can accurately assess their source of business, benchmark usage against competitors, and quantify areas of opportunity for their marketed or emerging brand.

Table of contents

  • Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis (Prophylaxis)
    • Treatment Algorithms CDA Migraine Prophylaxis US May 2020

Author(s): Jonathan Searles

Jonathan ;Searles is a Senior Director in the CNS/Ophthalmology unit at DRG, overseeing the neurology research stream. Prior to joining DRG, ;Searles received a degree, summa cum laude, from Brandeis University; during this time, Mr. Searles conducted research projects at the Harvard University Peabody Museum and at Brandeis.

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