Migraine | Pharmacor | G7 | 2014

Last Updated 4 December 2014
The migraine market consists of a multitude of therapies that either acutely treat migraine attacks or serve as prophylactic treatment. Among acute antimigraine therapies, triptans and NSAIDs/general analgesics are the most extensively prescribed. All the available triptan products, which constitute more than 60% of the total migraine major-market sales in 2013, have or will face generic competition during our 2013-2023 forecast period. However, the sales losses accompanying such generic competition will be countered by the uptake of emerging acute therapies—including several reformulations of existing products—and coupled with forecasted increases in both the acute and prophylactic drug-treated populations, the migraine market will grow from nearly $3.1 billion in 2013 to more than $5.4 billion in 2023. Despite the widespread genericization of the acute treatment market—the greatest extent will occur by the midyear of our forecast period—opportunity exists for acute antimigraine therapies that can offer improved efficacy over available triptans, or that can offer nontriptan pharmacological options to patients who do not respond to triptans or in whom triptans are contraindicated (e.g., those with cardiovascular risks). The most commercially promising emerging therapies, Allergan’s orally inhaled dihydroergotamine (DHE; Semprana [formerly Levadex]) and CoLucid’s 5-HT1F receptor agonist lasmiditan, will only partially fill the unmet need for acute nontriptan agents, yet each is forecast to garner significant peak-year sales. However, although a greater unmet need exists for new prophylactic therapies, we do not forecast any new prophylactic therapies to launch during the forecast period. Allergan’s onabotulinumtoxinA (Botox) is the branded prophylactic therapy currently available, and even though its use will largely be restricted to the chronic migraine population, we expect the drug will garner more than $810 million in major-market sales in 2023, demonstrating the commercial opportunity for premium-priced therapies that offer alternatives (particularly with improved tolerability) in the otherwise generic prophylactic market.