{"id":295529,"date":"2026-08-11T00:00:00","date_gmt":"2026-08-11T00:00:00","guid":{"rendered":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acrepn0001-2024-biopharma-migraine-access-reimbursement-access-reimbursement-migraine\/"},"modified":"2026-09-03T17:01:11","modified_gmt":"2026-09-03T17:01:11","slug":"acrepn0001-2026-biopharma-migraine-access-reimbursement-access-reimbursement-migraine-prophylaxis-us","status":"publish","type":"report","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acrepn0001-2026-biopharma-migraine-access-reimbursement-access-reimbursement-migraine-prophylaxis-us\/","title":{"rendered":"Migraine &#8211; Access &#038; Reimbursement &#8211; Access &#038; Reimbursement &#8211; Migraine Prophylaxis (US)"},"content":{"rendered":"<p>Preventive migraine care in the United States continues to evolve. Since 2018, <abbr title=\"calcitonin gene-related peptide\">CGRP<\/abbr>targeting mAbs (Aimovig, Emgality, Ajovy, Vyepti) and oral gepants (Nurtec <abbr title=\"orally disintegrating tablet\">ODT<\/abbr>, Qulipta) have become established options beyond legacy generics, especially in patients who have failed standard oral therapies. Qulipta\u2019s 2023 label expansion to chronic migraine has further entrenched the drug as an oral preventive option and intensified competition with monoclonal injectables and Botox. Ajovy has become the first anti<abbr title=\"calcitonin gene-related peptide\">CGRP<\/abbr> preventive approved for pediatric episodic migraine, broadening specialist and primary care use. While these premium-priced therapies have meaningfully broadened physician and patient choice, they have also driven higher overall spend. At the same time, class-wide safety updates (hypertension\/Raynaud\u2019s phenomenon) have reinforced the need for ongoing monitoring. Payers continue to actively manage utilization through utilization management strategies, making treatment sequencing increasingly critical. This report examines how U.S. primary care providers (<abbr title=\"primary care physician\">PCP<\/abbr>s) and neurologists have incorporated these new, premium-priced brands into their prescribing practices and how payer policies have impacted physicians\u2019 adoption of these agents.<\/p>\n<p><strong>QUESTIONS ANSWERED<\/strong><\/p>\n<ul class=\"round-bullets\">\n<li>\u00b7 What is the coverage status of key brands on commercial plans? What are common utilization management strategies that payers use to control costs?<\/li>\n<li>\u00b7 How do payer policies affect the prescribing of branded oral gepants (e.g., Nurtec <abbr title=\"orally disintegrating tablet\">ODT<\/abbr>, Qulipta) and <abbr title=\"calcitonin gene-related peptide\">CGRP<\/abbr> <abbr title=\"monoclonal antibody\">MAb<\/abbr>s in this genericized market?<\/li>\n<li>\u00b7 What are payers\u2019 and physicians\u2019 perspectives on Lundbeck\u2019s anti<abbr title=\"pituitary adenylate cyclase-activating polypeptide\">PACAP<\/abbr>38 <abbr title=\"monoclonal antibody\">MAb<\/abbr> as the drug progresses in the pipeline?<\/li>\n<li>\u00b7 What impact could Merz Therapeutics\u2019 Xeomin and Ipsen\u2019s Dysport have on AbbVie\u2019s Botox in migraine\u2014across clinical adoption, pricing\/contracting dynamics, payer policies, and step therapy?<\/li>\n<\/ul>\n<p><strong><strong>Geography:<\/strong><\/strong> United States<\/p>\n<p><strong><strong>P<\/strong><strong>rimary research: <\/strong><\/strong>Survey of 100 U.S. physicians (including 50 neurologists and 50 <abbr data-abbreviation-entity=\"4927\" title=\"primary care physician\">PCP<\/abbr>s). Survey of 30 U.S. managed care organization (<abbr title=\"managed care organization\">MCO<\/abbr>) pharmacy directors and medical directors (<abbr data-abbreviation-entity=\"5531\" title=\"pharmacy director\">PD<\/abbr>s\/<abbr title=\"medical director\">MD<\/abbr>s) and interviews with 2 U.S. <abbr title=\"managed care organization\">MCO<\/abbr> <abbr title=\"pharmacy director\">PD<\/abbr> \/ <abbr title=\"medical director\">MD<\/abbr>s<\/p>\n<p><strong><strong>F<\/strong><strong>ingertip Formulary: <\/strong><\/strong>Formulary coverage and restrictions data for migraine preventives by commercial plans covering 163 million lives nationally<\/p>\n<p><strong>Key drugs covered: <\/strong>Botox, Aimovig, Ajovy, Emgality, Vyepti, Trokendi <abbr title=\"extended release\">XR<\/abbr>, Qudexy <abbr title=\"extended release\">XR<\/abbr>, Nurtec <abbr title=\"orally disintegrating tablet\">ODT<\/abbr>, Qulipta, Xeomin, Dysport, Bocunebart<\/p>\n<p><strong>Key analyses<\/strong><\/p>\n<ul class=\"round-bullets\">\n<li>Reimbursement and contracting.<\/li>\n<li>Access and prescribing.<\/li>\n<li>Buy &#038; bill calculations and analysis<\/li>\n<li>Couponing and patient affordability.<\/li>\n<li>Opportunities and challenges for emerging therapies.<\/li>\n<\/ul>\n<p><strong>PRODUCT DESCRIPTION<\/strong><\/p>\n<p>Leveraging Clarivate\u2019s proprietary data sources and surveys with physicians and payers, Access &#038; Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of payer policy on physician prescribing behavior in the United States. Through detailed analyses of drug coverage, restriction policies, and contracting, as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies, this report enables you to:<\/p>\n<ul class=\"round-bullets\">\n<li>Identify and learn how to overcome roadblocks to market access to best position your brand.<\/li>\n<li>Identify key stakeholders and reimbursement drivers and assess the impact that reimbursement decisions have on treatment selection.<\/li>\n<li>Evaluate competitor strategies for securing favorable market access terms.<\/li>\n<\/ul>\n","protected":false},"template":"","class_list":["post-295529","report","type-report","status-publish","hentry","report-gateway-biopharma","biopharma-therapy-areas-migraine","biopharma-geography-us","biopharma-date-2609"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/295529","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report"}],"about":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/types\/report"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=295529"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}