For the estimated 36 million people in the United States who experience migraines, multiple prescription therapies are available that have proved effective in acutely treating migraine pain and its associated symptoms. Among approved prescription medications, the migraine-specific triptan drug class represents the largest—and most extensively prescribed—group of acute therapies, and the increasing genericization of this class will help maintain this drug class’s preferred status. All of the molecules in this class are available as oral tablet formulations, and several are also available in non-oral formulations (e.g., nasal sprays, subcutaneous [SC] injectables), which serve as alternative treatment options for patients with precise clinical needs. Additional therapies, including ergotamine derivatives and select non-migraine-specific analgesics, represent the remaining therapies formally approved for the acute treatment of migraine. Agents from these last two classes are generally reserved for patients who do not respond satisfactorily, cannot tolerate, or, in the case of non-migraine-specific analgesics, are contraindicated to triptans.
Using national patient-level claims data, the “Treatment Algorithms in Migraine—Acute Treatments” report explores the use of key acute antimigraine therapies and drug classes among treatment-naive and recently treated migraine patient populations. The report provides a quantitative analysis of treatment patterns and share of acute therapies by line of therapy, as well as progression between lines of acute treatment, duration of treatment on each line, and use of concomitant acute treatment, among treatment-naive patients. The report also quantifies an acute drug’s overall drug share and source of business compared with its competitors among recently treated patients, detailing which acute drugs precede others through an analysis of add-versus-switch patterns. Two additional claims database queries explore persistency and compliance by acute therapy.