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A Partial Win for People Living with Migraine

Complicated Review Finds Some New Medicines For Migraine Attacks Are Cost-Effective. Patients Deserve Access To All Medicines That Will Help Them To Effectively Manage Their Disease.

The 40 million Americans living with the pain and disability of migraine deserve access to medicines that help them to stop migraine attacks. Today the Institute for Clinical and Economic Review (ICER) released their Final Report showing that Ubrelvy (ubrogepant) and rimegepant are very cost-effective treatments for migraine patients who don’t respond adequately or cannot tolerate other acute treatments. The report also finds Reyvow (lasmiditan) is an effective treatment, but falls just outside of their cost-effectiveness threshold.

The Coalition For Headache And Migraine Patients (CHAMP) and Headache & Migraine Policy Forum (HMPF) have been active participants in the ICER review process and we credit ICER for their willingness to include diverse stakeholders and update their analysis model based on feedback. We continue to have concerns that the ICER approach under-counts the real economic costs of migraine disease and under-values the benefits of these new medicines.

This review is one of the last that ICER is conducting under its old analytic framework before switching to a new framework that will incorporate a modified societal perspective within its base case analysis. Because of the high societal impact of migraine (the second leading cause of global disability according to the World Health Organization), we call on ICER to re-run the analysis on these three acute treatments for migraine attacks using the new framework with a greater inclusion of societal factors. We believe this will improve the cost-effectiveness rating for all three medicines and should move the Reyvow (lasmiditan) rating to within their cost-effectiveness threshold.

Migraine is a complex neurological disease that manifests with varying severity and symptoms across patients. Multiple pathways are involved in causing migraine, thus physicians and patients need access to a broad range of therapies to find the right one or combination of treatments that work individually for them. With many migraine treatments being decades old, it is vital that physician attestation be widely accepted in determining when patients have been failed by or can’t use older medicines. We call on insurance companies and other payors in the U.S. healthcare system to ensure that people living with migraine have access to all therapies that can help them to effectively manage their disease.

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