According to DRG epidemiology, over 30 million people in the EU5 suffer migraines and over 10% of migraineurs suffer chronic migraine. Migraine prophylaxis is a core treatment approach for high-frequency episodic and chronic migraine patients to reduce migraine frequency, severity, and duration. Current drug treatment primarily includes a mix of off-label and approved antiepileptic drugs, beta blockers, tricyclic antidepressants, Botox (Allergan’s onabotulinumtoxinA), and—now—multiple anti-CGRP monoclonal antibodies (MAbs), the first migraine-specific preventive brands. With many agents to choose from and a heterogeneous patient population, prophylactic treatment is individualized, complex, and evolves over time. Understanding patient pathways and drivers of treatment decision-making is key for new players bringing novel brands to this large and underserved, but mostly generic, market.


  • What patient share do oral standards of care and injectable brands garner overall, and by line of therapy, in migraine patients treated with prophylaxis?
  • What are the drivers and constraints influencing physicians’ treatment decisions and choice of therapy for migraine prophylaxis across the EU5?
  • What role do Botox and the anti-CGRP MAbs play in the evolving treatment algorithm? Which MAb garners the most use, and why?
  • What percentage of migraine patients are treated with monotherapy versus combination therapy? How long are migraineurs treated with prophylaxis?


Current Treatment: Physician Insightsprovides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

Table of contents

  • Migraine - Current Treatment - Detailed, Expanded Analysis (EU5)
    • Current Treatment Physician Insights Migraine Prophylaxis EU5 November 2020

Author(s): Nakka Meher Baba Kumar; Jonathan Searles

Jonathan W. Searles is a Senior Director in the CNS/Ophthalmology unit at DRG, overseeing the neurology research stream. Prior to joining DRG, Mr. Searles received a B.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.

Related Reports

Migraine - Landscape & Forecast - Disease Landscape & Forecast

The market for prescription migraine therapies comprises an array of

View Details

Migraine | Disease Landscape and Forecast | G7 | 2020

The market for prescription migraine therapies comprises an array of acute and prophylactic treatments and fosters a large and dynamic pipeline. In the acute space, we anticipate the launch of seve...

View Details

Migraine - Geographic Focus: China - Migraine - China In-Depth (China)

Migraine presents a major public health burden in China, leading to impaired quality of life, widespread health loss, and loss of productivity for a sizeable population. Owing to migraine’s n...

View Details

Migraine - Unmet Need - Detailed, Expanded Analysis Acute Migraine

A range of oral and nonoral triptans (e.g., sumatriptan) are available for the acute treatment of migraine and are entrenched in medical practice. However, triptans have noted clinical shortcomings...

View Details