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.

Questions Answered:

  • 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?

Product Description:

Disease Landscape & Forecast provides comprehensive market intelligence with world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary research.

Solution Enhancement Disease Landscape & Forecast will feature continuous updates in 2021 to provide timely insights and analyses as meaningful indication-specific news and events unfold.

Table of contents

  • Migraine - Landscape & Forecast - Disease Landscape & Forecast
    • Key Updates
      • Q2 2021
        • June 2021
        • May 2021
        • April 2021
      • Q1 2021
        • March 2021
        • February 2021
        • January 2021
      • Q4 2020
        • December 2020
      • Q3 2020
        • September 2020
      • Q2 2020
        • May 2020
    • Key Findings
      • Migraine Key Findings - January 2021
        • May 2020
    • Market Outlook
      • Key Findings
        • Market Share of Drug Classes for the Acute Treatment of Migraine in 2019
        • Market Share of Drug Classes for the Acute Treatment of Migraine in 2029
        • Market Share of Drug Classes for the Prophylactic Treatment of Migraine in 2019
        • Market Share of Drug Classes for the Prophylactic Treatment of Migraine in 2029
        • Migraine SWOT Analysis
      • COVID-19: Areas of Potential Forecast Impact
        • Expert Insight: Areas of Potential Impact of COVID-19
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Migraine?
        • What Factors Are Constraining the Market for Migraine?
        • Market Share and Treated Patients for Acute Migraine by Country: 2019 and 2029
        • Market Share and Treated Patients for Migraine Prophylaxis by Country: 2019 and 2029
      • Segment-Specific Trends
        • Sales of Acute and Prophylactic Treatments in the Episodic and Chronic Migraine Markets: 2019 and 2029
      • Drug-Class-Specific Trends
        • Major-Market Sales of Key Triptans in Acute Migraine: 2019-2029
        • Major-Market Patient Share of Key Triptans in Acute Migraine: 2019-2029
        • U.S. Sales of Emerging Acute Treatments in Migraine: 2019-2029
        • Anti-CGRP Monoclonal Antibodies
        • CGRP Receptor Antagonists
        • Major-Market Sales of CGRP-Targeted Therapies for Migraine Prophylaxis: 2019-2029
        • Major-Market Patient Share of CGRP-Targeted Therapies for Migraine Prophylaxis in Episodic Migraine: 2019-2029
        • Major-Market Patient Share of CGRP-Targeted Therapies for Migraine Prophylaxis in Chronic Migraine: 2019-2029
        • Major-Market Sales of Other Prophylactic Treatments in Migraine: 2019-2029
        • Major-Market Patient Share of Other Prophylactic Treatments in Migraine: 2019-2029
    • Forecast
      • Market Forecast Assumptions: Acute Migraine
      • Market Forecast Dashboard: Acute Migraine
      • Market Forecast Assumptions: Migraine Prophylaxis
      • Market Forecast Dashboard: Migraine Prophylaxis
    • Etiology and Pathophysiology
      • Disease Overview
        • Anatomy of the Brain
      • Genetic Factors
        • Environmental Factors: Migraine Triggers
          • Select Precipitating (Trigger) Factors Associated with Migraine
        • Key Pathways and Drug Targets
          • Substances Involved in Neurotransmission in Migraine
          • Role of Select 5-HT Receptor Subtypes in Migraine
          • Neurogenic Inflammation in Migraine
          • Neurogenic Inflammation in Migraine Headache
          • Progression of Spreading Depression and Oligemia Believed to Be Associated with Migraine Aura
          • Other Processes Involved in Migraine
      • Epidemiology
        • Key Findings
          • Epidemiology Populations
            • Disease Definition
            • Sources Used for Total Prevalent Cases of Migraine
            • 12-Month Total Migraine Cases in the Major Pharmaceutical Markets: 2019-2029 (thousands)
            • Disease Definition
            • Methods
            • Sources Used for Total Prevalent Cases of Episodic Migraine
            • Total 12-Month Episodic Migraine Cases in the Major Pharmaceutical Markets: 2019-2029 (thousands)
            • Disease Definition
            • Sources Used for Total Prevalent Cases of Chronic Migraine
            • Total 12-Month Chronic Migraine Cases in the Major Pharmaceutical Markets: 2019-2029 (thousands)
            • Disease Definition
            • Methods
            • Sources Used for Frequency of Episodic Migraine Attacks
            • Total 12-Month Episodic Migraine Cases According to Frequency of Attacks in the Major Pharmaceutical Markets: 2019-2029 (thousands)
            • Disease Definition
            • Methods
            • Sources Used for Total Episodic Migraine Events
            • Total 12-Month Episodic Migraine Events in the Major Pharmaceutical Markets: 2019-2029 (thousands)
            • Diagnosed Prevalent Cases of Episodic Migraine: 2019-2029 (thousands)
            • Diagnosed Prevalent Cases of Chronic Migraine: 2019-2029 (thousands)
            • Acute Migraine Treatment
            • Acutely Drug-Treated Prevalent Cases of Episodic Migraine: 2019-2029 (thousands)
            • Acutely Drug-Treated Prevalent Cases of Chronic Migraine: 2019-2029 (thousands)
            • Migraine Prophylaxis
            • Prophylactically Drug-Treated Prevalent Cases of Episodic Migraine: 2019-2029 (thousands)
            • Prophylactically Drug-Treated Prevalent Cases of Chronic Migraine: 2019-2029 (thousands)
        • Current Treatment
          • Key Findings
            • Treatment Goals
              • Key Endpoints Used in Clinical Trials for Migraine
            • Key Current Therapies: Acute Treatment
              • Overview
              • Mechanism of Action of Key Current Drug Classes Used for the Acute Treatment of Migraine
              • Current Treatments Used for the Acute Treatment of Migraine
              • Market Events Impacting the Use of Key Current Acute Therapies in Migraine
              • Advantages and Disadvantages of Sumatriptan
              • Expert Insight: Sumatriptan
              • Advantages and Disadvantages of Treximet
              • Expert Insight: Treximet
              • Advantages and Disadvantages of Rizatriptan
              • Advantages and Disadvantages of Frovatriptan
              • Advantages and Disadvantages of Zolmitriptan
              • Expert Insight: Zolmitriptan
              • Advantages and Disadvantages of Other Triptans
              • Advantages and Disadvantages of Reyvow
              • Key Results from Select Clinical Trials Investigating Reyvow for the Acute Treatment of Migraine
              • Ongoing Clinical Development of Reyvow
              • Expert Insight: Reyvow
              • Key Results from Select Clinical Trials Investigating Ubrelvy for the Acute Treatment of Migraine
              • Ongoing Clinical Development of Ubrelvy
              • Expert Insight: Ubrelvy
              • Advantages and Disadvantages of Nurtec ODT
              • Key Results from Select Clinical Trials Investigating Nurtec for the Acute Treatment of Migraine
              • Key Results from Clinical Trials Investigating Nurtec for the Prophylactic Treatment of Migraine
              • Ongoing Clinical Development of Nurtec ODT
              • Expert Insight: Nurtec ODT
              • Advantages and Disadvantages of Dihydroergotamine Mesylate
              • Expert Insight: Dihydroergotamine Mesylate
              • Advantages and Disadvantages of Prescription NSAIDs and Nonnarcotic Analgesics
              • Advantages and Disadvantages of Narcotic Prescription Analgesics
            • Key Current Therapies: Prophylactic Treatment
              • Overview
              • Mechanism of Action of Key Current Drug Classes Used for the Prophylactic Treatment of Migraine
              • Current Treatments Used for the Prophylactic Treatment of Migraine
              • Market Events Impacting the Use of Key Current Preventive Therapies in Migraine
              • Advantages and Disadvantages of Topiramate
              • Advantages and Disadvantages of Divalproex
              • Advantages and Disadvantages of Botox
              • Advantages and Disadvantages of Aimovig
              • Key Results from Select Clinical Trials Investigating Aimovig for the Prophylactic Treatment of Migraine
              • Ongoing Clinical Development of Aimovig
              • Expert Insight: Aimovig
              • Advantages and Disadvantages of Ajovy
              • Key Results from Select Clinical Trials Investigating Ajovy for the Prophylactic Treatment of Migraine
              • Ongoing Clinical Development of Ajovy
              • Advantages and Disadvantages of Emgality
              • Key Results from Select Clinical Trials Investigating Emgality for the Treatment of Migraine
              • Expert Insights: Emgality
              • Advantages and Disadvantages of Vyepti
              • Key Results from Select Clinical Trials Investigating Vyepti for the Treatment of Migraine
              • Ongoing Clinical Development Program of Vyepti
              • Advantages and Disadvantages of Beta Blockers
              • Advantages and Disadvantages of Amitriptyline
              • Advantages and Disadvantages of Calcium Channel Blockers
            • Medical Practice
              • Overview
              • Migraine Treatment Guidelines by Market
              • Factors Influencing Drug Selection in Migraine
              • Treatment Decision Tree for the Acute Treatment of Migraine: United States
              • Treatment Decision Tree for the Prophylactic Treatment of Migraine: United States
              • Treatment Decision Tree for the Acute Treatment of Migraine: Europe
              • Treatment Decision Tree for the Prophylactic Treatment of Migraine: Europe
              • Treatment Decision Tree for the Acute Treatment of Migraine: Japan
              • Treatment Decision Tree for the Prophylactic Treatment of Migraine: Japan
          • Unmet Need Overview
            • Current and Future Attainment of Unmet Needs in Migraine
            • Top Unmet Needs in Migraine: Current and Future Attainment
            • Expert Insight: Unmet Need in Migraine
          • Emerging Therapies
            • Key Findings
              • Key Emerging Therapies
                • Key Therapies in Development for Migraine
                • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Migraine
                • Qtrypta Profile
                • Analysis of Clinical Development Program for Qtrypta
                • Expert Insight: Qtrypta (M-207)
                • Expectations for Launch and Sales Opportunity of Qtrypta (M-207) in Migraine
                • AXS-07
                • AXS-07 Profile
                • Analysis of Clinical Development Program for AXS-07
                • Expert Insight: AXS-07
                • Expectations for Launch and Sales Opportunity of AXS-07 in Migraine
                • INP-104 Profile
                • Analysis of Clinical Development Program for INP-104
                • Expectations for Launch and Sales Opportunity of INP-104 in Migraine
                • STS101
                • STS101 Profile
                • Analysis of Clinical Development Program for STS101
                • Expert Insight: STS101
                • Expectations for Launch and Sales Opportunity of STS101 in Migraine
                • Elyxyb (DFN-15) Profile
                • Analysis of the Clinical Development Program for DFN-15
                • Expert Insight: Elyxyb (DFN-15)
                • Expectations for Launch and Sales Opportunity of Elyxyb (DFN-15) in Migraine
                • Atogepant Profile
                • Analysis of Clinical Development Program for Atogepant
                • Expert Insight: Atogepant
                • Expectations for Launch and Sales Opportunity of Atogepant in Migraine
                • Zavegepant Profile
                • Analysis of Clinical Development Program for Zavegepant
                • Expert Insight: Zavegepant
                • Expectations for Launch and Sales Opportunity of Zavegepant in Migraine
              • Early-Phase Pipeline Analysis
                • Select Compounds in Early-Phase Development for the Acute Treatment of Migraine
                • Select Compounds in Early-Phase Development for the Prophylactic Treatment of Migraine
            • Access & Reimbursement Overview
              • Region-Specific Reimbursement Practices
                • Key Market Access Considerations in Migraine: United States
                • General Reimbursement Environment: United States
                • Key Market Access Considerations in Migraine: EU5
                • General Reimbursement Environment: EU5
                • Key Market Access Considerations in Migraine: Japan
                • General Reimbursement Environment: Japan
            • Appendix
              • Key Abbreviations Related to Migraine
              • Brands, Marketers, and Generic Availability of Key Therapies for Migraine by Market
              • Migraine Bibliography

          Author(s): Ruchita Kumar, Ph.D.; Shilpa Thakur

          Ruchita Kumar, M.Pharm., Ph.D., is a manager on the CNS/Ophthalmology Disorders team at Clarivate. Her specialties are migraine and Alzheimer’s disease. She has worked on a variety of opportunity assessment and market intelligence projects involving the preparation of disease narratives, epi-based forecasts, and building brand performance reports across different therapy areas. She holds a Ph.D. in the design and development of modified-release dosing forms of antidiabetic drugs from the University Institute of Pharmaceutical Sciences at Panjab University in Chandigarh, India.

          Shilpa Thakur, M.P.H., is an epidemiologist at Clarivate. Previously, she monitored HIV sentinel surveillance in Himachal Pradesh. She has also studied the patterns of antimicrobial resistance in India. She received her M.P.H. from the Postgraduate Institute of Medical Education and Research with a specialization in epidemiology and biostatistics.


          Related Reports

          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 - Current Treatment - Detailed, Expanded Analysis (EU5)

          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-fre...

          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