2020 will be a turning point for the U.S. acute migraine market. Three novel therapies—Allergan’s Ubrelvy, Eli Lilly’s Reyvow, and Biohaven’s Nurtec ODT—entered the market in rapid succession, becoming the first novel, migraine-specific therapies to be approved in the acute segment in nearly two decades. Meanwhile a range of additional acute products are advancing through late-phase development. This report assesses how U.S. physicians and payers will react to new, premium-priced brands entering a mostly generic market, and how payer policies will affect physicians’ adoption.
- What formulary coverage do current acute migraine SoC treatments and brand-only products receive on commercial insurance plans today? What approaches do payers use to manage utilization / costs of these drugs?
- Given the market entry of novel therapies, what strategies will payers use to control rising costs in acute migraine? How will these restrictions impact neurologists’ prescribing practices?
- What points of clinical differentiation are/will be most compelling to neurologists and most convincing to payers?
- What discounts will payers expect to negotiate? What pharmacoeconomic data and contracting terms will be most influential in driving coverage decisions?
U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.
Survey of 100 U.S. physicians (including 50 neurologists and 50 PCPs).
Survey of 31 U.S. managed care organization (MCO) pharmacy directors and medical directors (PDs/MDs).
Formulary coverage and restrictions data for acute migraine therapies by commercial plans covering approximately 168 million lives nationally.
Key Drugs Covered
Reyvow (lasmiditan), Ubrelvy (ubrogepant), Nurtec ODT (rimegepant), Elyxyb, AXS-07, Rizaport, Qtrypta, INP104, STS101, zavegepant (vazegepant), current SoC treatments.
- Reimbursement and contracting.
- Access and prescribing.
- Adoption of Reyvow, Ubrelvy, and Nurtec ODT.
- Opportunities and challenges for emerging therapies.
- Migraine - Access & Reimbursement - Detailed, Expanded Analysis (US) - Acute Migraine
- U.S. Access and Reimbursement - Acute Migraine [September 2020]
Author(s): Ruchita Kumar, Ph.D
Ruchita has joined as a Lead Analyst in the Central Nervous System and Ophthalmology team at Decision Resources Group.
She comes with eight years of experience in handling various types of commercial assessment projects. She has worked on variety of opportunity assessment and market intelligence projects involving preparation of disease narratives, epi-based forecasts, patent landscapes, social media analysis and building brand performance reports across different therapy areas. She earned a Ph.D. in design and development of modified release dosage forms of anti-diabetic drugs from the University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh.