According to DRG epidemiology, more than 33 million people in the EU5 suffer from migraines and over 10% of migraineurs suffer from chronic migraine (CM). Migraine prophylaxis is a core treatment approach for high-frequency EM and CM patients to reduce migraine frequency, severity, and duration. Drug treatment primarily includes a mix of off-label and approved AEDs, beta blockers, TCAs, and Botox (Allergan’s onabotulinumtoxinA), the only agent approved specifically for CM. 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 drug, market.


  • What patient share do key therapies and brands garner by line of therapy in migraine patients initiating prophylaxis?
  • What are the drivers and constraints influencing physicians’ treatment decisions for migraine prophylaxis across the EU5? How are patients being treated across different lines of therapy?
  • How is Botox integrated into the treatment algorithm?
  • What percentage of migraine patients are treated with monotherapy versus combination therapy? What are the most widely used combination therapies?
  • How do physicians think their prescribing will change upon the launch of anti-CGRPMAbs?


Current Treatment: Physician Insights provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so you can create specific messaging around these treatment dynamics in order to more effectively increase or defend your market position.

Table of contents

  • Migraine - Current Treatment - Detailed, Expanded Analysis (EU5) - Migraine Prophylaxis

Author(s): Audreza Das, P.G. Dip. ; Jonathan Searles

Audreza Das is a Senior Analyst in the CNS/Ophthalmology team at Decision Resources Group

She has authored content across indications, including neuropathic pain, age-related macular degeneration, treatment-related depression, painful diabetic neuropathy, and migraine. Ms. Das has previously worked at Novo Nordisk, as a Market Analyst for European markets. Previous experience at a SME, included developing disease competitive landscapes, covering global conferences etc. Ms. Das received her B.E. degree in Biotechnology from Birla Institute of Technology, a deemed university and her P.G. Diploma in Cancer Immunology & Biotechnology from University of Nottingham.

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 - 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 - Access & Reimbursement - Detailed, Expanded Analysis (US) - Acute Migraine

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

View Details

Migraine - Landscape & Forecast - Disease Landscape & Forecast

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

View Details

Migraine - Current Treatment - Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis (Prophylaxis)

According to DRG epidemiology, more than 35 million people in the United States suffer from migraines. Despite being underu...

View Details