Prophylactic therapy for migraine is prescribed to reduce the frequency, severity, and duration of migraine attacks and to increase the responsiveness of these 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 injectables (Amgen/Novartis’s Aimovig, Teva’s Ajovy, Eli Lilly’s Emgality, and, more recently in select European markets, Lundbeck’s Vyepti) is transforming the paradigm, with further changes expected following the anticipated entry of oral prophylactic agents in Europe, including Pfizer’s Vydura (Nurtec ODT) and AbbVie’s Qulipta. 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., general practitioners / internal medicine physicians [GPs / IMs], neurologists). Understanding prescribing patterns and drivers is paramount for established agents competing for market share and for developers of emerging treatments.
QUESTIONS ANSWERED
- How do GP/IMs 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 will the entry of the oral CGRP-targeted therapies have on the prescribing of anti-CGRP MAbs, and what factors will drive 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 reevaluate whether to continue treatment?
PRODUCT DESCRIPTION
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.
- Migraine - Current Treatment - Detailed, Expanded Analysis (EU5)
- Current Treatment Physician Insights Migraine Prophylaxis EU5 May 2023
Shayan Chakraborty
Shayan Chakraborty is a senior healthcare research and data analyst on the CNS/Ophthalmology Disorders team at Clarivate. In this role, he oversees the team’s syndicated research stream in neurology, with a core focus on migraine. He has several years of experience working in the pharmaceutical industry providing analytical support in various therapy areas, including oncology, vaccines, specialty pharma, and rare diseases.
Prior to joining Clarivate, he was an assistant manager at WNS Global Services, where he was responsible for providing analytical and forecasting support to Global Vaccine Business Insight partners for early-phase products. He holds a bachelor’s degree in biotechnology from West Bengal University of Technology and a master’s degree in biotechnology and biochemical engineering from the Indian Institute of Technology, Kharagpur. Currently, he is pursuing India’s first full-time online bachelor’s degree in data science and programming from the Indian Institute of Technology, Madras.
Andrea Witt, Ph.D.
Andrea S. Witt, Ph.D., is Director of the Central Nervous System and Ophthalmology Disorders Portfolio at Clarivate, where she oversees a team of Business Insights Analysts and Senior Directors responsible for market research encompassing Neurology, Psychiatry, Pain, and Ophthalmology.
Her interests beyond specific CNS indications included the market potential for neuroprotectants and the impact of biomarkers on CNS markets. Dr. Witt’s research, analysis, and commentaries have appeared in Barron’s, Pharmaceutical Executive, PharmaVoice, Nature Medicine, and CNBC. Dr. Witt’s previous experience includes 10 years of scientific research conducted on neurodegenerative disorders at Harvard Medical School/Brigham and Women’s Hospital, Duke University, and the University of Texas-Southwestern Medical Center, where she earned her Ph.D. degree.