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 several new brands, including novel triptan and DHE reformulations and promising nontriptan NMEs. Among them are Eli Lilly’s Reyvow and two oral calcitonin gene-related peptide (CGRP) receptor antagonists—Allergan’s Ubrelvy and Biohaven’s Nurtec ODT—which together will drive strong growth in the large acute segment. In fact, it is the launch of four premium-priced anti-CGRP monoclonal antibodies and the two oral gepants for episodic and chronic migraine prevention that will be the main driver of multibillion-dollar sales. These drugs follow in the footsteps of Allergan’s Botox (approved for chronic migraine), which has proven the commercial opportunity that new, valued brand alternatives can seize in the otherwise generic prophylaxis segment.
- How will Amgen / Novartis’s Aimovig, Teva’s Ajovy, Eli Lilly’s Emgality, and Lundbeck / Alder’s eptinezumab compete with one another and with established prophylactic therapies as their marketers vie for patient share? How will the launch of oral CGRP receptor antagonists atogepant and Nurtec impact the migraine prophylaxis market?
- Will NMEs Reyvow, Ubrelvy, and Nurtec ODT gain a foothold in the heavily generic acute segment dominated by triptans?
- How will new nonoral reformulations compete for patient share with existing brands and generics in the small niche patient population in need of nonoral alternatives?
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