Migraine – Current Treatment – Detailed, Expanded Analysis – Migraine Prophylaxis (US)

Prophylactic therapy for migraine is prescribed to reduce migraine frequency, severity, and duration of attacks and to increase responsiveness of attacks to acute treatment. Generic oral AEDs (e.g., topiramate), beta blockers (e.g., propranolol), antidepressants (e.g., amitriptyline), and AbbVie’s Botox are historical mainstays, but an influx of novel CGRP-targeting injectable (Amgen/Novartis’s Aimovig, Teva’s Ajovy, Eli Lilly’s Emgality, and Lundbeck’s Vyepti) and oral (Pfizer’s Nurtec ODT and AbbVie’s Qulipta) prophylactic agents is transforming the paradigm. Although they target a common pathway, these novel agents differ meaningfully in their clinical profile, in addition to their route and frequency of administration; as such, they appeal differentially to patients and the various specialists prescribing prophylactic treatment (e.g., PCPs, neurologists). Understanding prescribing patterns and drivers is paramount for established agents competing for market share and for developers of emerging treatments.


  • How do PCPs and neurologists differ in their prescribing for migraine prophylaxis?
  • What patient share do key prophylactic therapies and brands attain in chronic and episodic migraine patients and by line of therapy in migraine patients initiating prophylaxis?
  • What impact has the entry of the oral CGRP-targeted therapies had on the prescribing of anti-CGRP MAbs, and what drives this dynamic?
  • Which anti-CGRP MAbs perform best on key clinical factors? Which are most prescribed, and why?
  • What impact has the emergence of anti-CGRP MAbs had on the prescribing of Botox, and what drives this dynamic?
  • What percentage of patients are treated with monotherapy versus combination therapy? What are the most common combinations?
  • What are physicians’ goals regarding the duration of prophylactic therapy, and at what point do they re-evaluate whether to continue it?


Current Treatment: Physician Insights provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

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