{"id":295529,"date":"2024-05-10T00:00:00","date_gmt":"2024-05-10T00:00:00","guid":{"rendered":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acrepn0001-2024-biopharma-migraine-access-reimbursement-access-reimbursement-migraine\/"},"modified":"2026-04-18T11:21:39","modified_gmt":"2026-04-18T11:21:39","slug":"acrepn0001-2024-biopharma-migraine-access-reimbursement-access-reimbursement-migraine-prophylaxis-us","status":"publish","type":"report","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acrepn0001-2024-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>Since 2018, the U.S. treatment landscape for migraine prophylaxis has undergone a major expansion with the entry of the novel calcitonin gene-related peptide (<abbr title=\"calcitonin gene-related peptide\">CGRP<\/abbr>)-targeting monoclonal antibodies (<abbr title=\"monoclonal antibody\">MAb<\/abbr>s) Aimovig (Novartis \/ Amgen), Emgality (Eli Lilly), Ajovy (Teva), and Vyepti (Lundbeck), followed by the oral <abbr title=\"calcitonin gene-related peptide\">CGRP<\/abbr> antagonists (gepants) Nurtec <abbr title=\"orally disintegrating tablet\">ODT<\/abbr> (Pfizer) and Qulipta (AbbVie). Use of these classes has grown steadily, driven by unmet need and solid efficacy, especially in patients who fail standard oral therapies. Competition is set to intensify, with the expanded labeling of the oral gepants hampering the uptake of the <abbr title=\"monoclonal antibody\">MAb<\/abbr>s and long-established Botox. As high-cost alternatives, <abbr title=\"calcitonin gene-related peptide\">CGRP<\/abbr>-targeting agents have both increased the number of treatments and substantially increased the cost of care in a previously highly genericized market. This report assesses how U.S. primary care physicians (<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 are affecting physicians\u2019 adoption of these agents.<\/p>\n<p><strong>QUESTIONS ANSWERED<\/strong><\/p>\n<ul class=\"round-bullets\">\n<li>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>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>What will be the anticipated impact of the label expansion of Qulipta\u2014from just chronic migraine to all migraine frequencies\u2014on payer policies and physician prescribing patterns for migraine prophylaxis?<\/li>\n<li>What are payers\u2019 and physicians\u2019 perspectives on the only emerging agent (Pfizer\u2019s oral zavegepant) for migraine prophylaxis as the drug progresses in the pipeline?<\/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 32 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)<\/p>\n<p><strong><strong>F<\/strong><strong>ingertip Formulary: <\/strong><\/strong>Formulary coverage and restrictions data for migraine preventives by commercial plans covering 169 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<\/p>\n<p><strong>CONTENT HIGHLIGHTS<\/strong><\/p>\n<ul class=\"round-bullets\">\n<li>Reimbursement and contracting.<\/li>\n<li>Access and prescribing.<\/li>\n<li>Affordability of migraine therapies.<\/li>\n<li>Opportunities and challenges for emerging therapies.<\/li>\n<\/ul>\n<p><strong>PRODUCT DESCRIPTION<\/strong><\/p>\n<p>U.S. Access &#038; Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment. Each report includes up-to-date analyses of drug coverage and restriction policies as well as payer and prescriber perspectives on key marketed drugs and their receptivity to emerging therapies.<\/p>\n<p><strong>SOLUTION ENHANCEMENT<\/strong><\/p>\n<p>Access &#038; Reimbursement includes key analyses from Clarivate Real-World Data Product\u2014comprehensive and timely data that provide clarity around the healthcare experiences and activities of hundreds of millions of patients, <abbr title=\"healthcare provider\">HCP<\/abbr>s, and payers. Analyses include payer mix, percentage of claim rejections for key therapies, and reasons for claim rejection.<\/p>\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-985"],"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"}],"version-history":[{"count":10,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/295529\/revisions"}],"predecessor-version":[{"id":575966,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/295529\/revisions\/575966"}],"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}]}}