Migraine | Disease Landscape and Forecast | G7 | 2016

The migraine market consists of a multitude of therapies that either acutely treat migraine attacks or serve as prophylactic treatment. Among acute antimigraine therapies, triptans and NSAIDs/general analgesics are the most extensively prescribed. All the available triptan products, which we estimate contributed approximately half of migraine major-market sales in 2015, already do, or will, face generic competition during our 2015-2025 forecast period. Nevertheless, the uptake of emerging acute therapies, including new triptan reformulations and promising nontriptan alternatives for patients who do not respond to triptans or in whom triptans and/are contraindicated (, those with cardiovascular risks) will support approximately 7% annual growth in the acute segment during the forecast period. These new brands include CoLucid’s 5-HT1F receptor agonist lasmiditan, Allergan’s Semprana (orally inhaled dihydroergotamine), and Allergan’s calcitonin gene-related peptide (CGRP) receptor antagonist ubrogepant; while these productswill only partially fill the unmet need for acute nontriptan agents, each is forecast to garner significant peak-year sales of almost $2 billion combined in 2025. However, it is the expected launch of four new, premium-priced anti-CGRP MAbs for migraine prophylaxis in both episodic and chronic migraineurs ​that will be the main driver of substantial forecast sales growth from approximately $ billion in 2015 to over $10 billion in 2025. Allergan’s Botox , which will remain a useful option for the treatment of chronic migraine and garner more than $800 million in major-market sales in 2025, demonstrates the commercial opportunity for premium-priced therapies that offer alternatives (particularly with improved tolerability) in the otherwise generic prophylactic market. 

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