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 in efficacy and adverse events that create opportunities for new and improved acute migraine drugs—three of which entered the U.S. market in H1 2020. These agents became the first migraine-specific acute therapies to be approved in nearly two decades. This report provides quantitative insight into neurologists’ perceptions of key treatment drivers and goals in the acute management of migraine and the current level of unmet need in this area. We analyze the commercial opportunities and how new / emerging compounds may capitalize on these opportunities.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals in the management of acute migraine?
  • What drug attributes are key influences, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals?
  • What are the prevailing areas of unmet need and opportunity in the acute management of migraine?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European neurologists for a hypothetical new drug for the acute treatment of migraine?

PRODUCT DESCRIPTION

Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, United Kingdom, France, Germany.

Primary research: Survey of 60 U.S. and 30 European neurologists fielded in August 2020.

Key drugs: Triptans (e.g., sumatriptan [multiple formulations]), DHE nasal spray, Reyvow, Ubrelvy, and Nurtec ODT.

Table of contents

  • Migraine - Unmet Need - Detailed, Expanded Analysis Acute Migraine
    • Executive Summary
      • Unmet Need - Acute Migraine - Executive Summary - October 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products for the Acute Treatment of Migraine and Rationale for Drug Selection
      • Treatment Drivers and Goals
        • Key Findings: Attribute Importance
        • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Neurologists' Prescribing Decisions in Acute Migraine
        • Importance of Efficacy Attributes to Prescribing Decisions in Treatment of Acute Migraine: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Treatment of Acute Migraine: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Treatment of Acute Migraine: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Treatment of Acute Migraine: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Treatment of Acute Migraine: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Treatment of Acute Migraine: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in Treatment of Acute Migraine: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in Treatment of Acute Migraine: Europe
        • Key Findings: Stated vs. Derived Importance
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Acute Migraine: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Acute Migraine: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Acute Migraine: United States
        • Overall Performance of Key Therapies for Acute Migraine: Europe
        • Mean Overall Performance of Key Therapies for Acute Migraine: United States and Europe
        • Relative Performance of Key Therapies for Acute Migraine Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Acute Migraine Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Acute Migraine Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Acute Migraine Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Acute Migraine Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Acute Migraine Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for Acute Migraine Across Select Nonclinical Attributes: United States
        • Relative Performance of Key Therapies for Acute Migraine Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Acute Treatment of Migraine
        • Surveyed Neurologists’ Satisfaction with the Performance of Key Therapies for Acute Migraine on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Neurologists’ Satisfaction with the Performance of Key Therapies for Acute Migraine on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Acute Migraine: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Acute Migraine: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Acute Migraine: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Acute Migraine: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Acute Migraine: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Acute Migraine: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Acute Migraine: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Acute Migraine: Europe
        • Key Findings: Unmet Need in Migraine and Related Indications
        • Surveyed Neurologists' Ascribed Level of Unmet Need in Migraine and Related Indications: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need in Migraine and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Acute Migraine Market and Emerging Therapy Insights
          • Opportunity: Safer, More-Effective Migraine-Specific Nontriptan Alternatives
          • Opportunity: Improved Nonoral Treatments
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
          • Attributes of Key Current Therapies for the Treatment of Acute Migraine
        • Attribute Importance and Part-Worth Utilities
          • Acute Migraine Target Product Profile: Attribute Importance
          • % of patients with pain relief at 2 hours (placebo-adjusted)
          • % of patients with pain freedom at 2 hours (placebo-adjusted)
          • % of patients with MBS freedom at 2 hours (placebo-adjusted)
          • % of patients with sustained freedom from pain at 2-24 hours (placebo-adjusted)
          • Safety and Tolerability Profile
          • Formulation
          • Price per dose
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • Market Scenario
          • Acute Migraine Market Simulation: Target Product Profiles Included in the Market Scenario
          • Acute Migraine Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • Acute Migraine Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Bibliography

    Author(s): Joyce Spadafora, ALM

    Joyce is a business insights analyst in Decision Resources Group’s central nervous systems and ophthalmology division, where she provides expert insight into commercial aspects of drug development and market sizing across psychiatric and pain indications. She has worked extensively in DRG’s schizophrenia and chronic pain content.

    Prior to joining DRG, Joyce spent several years in the biotech industry focused in research and development and in biotech consulting. Her project experience covered indications including psychiatry, pain, infectious diseases, respiratory, and ophthalmology. Beyond my therapeutic and industry knowledge, she holds a Masters in Extension Studies in Psychology from Harvard University and a B.S in Mechanical Engineering with Biology from the Massachusetts Institute of Technology.


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