Migraine – Unmet Need – Detailed, Expanded Analysis: Migraine Prophylaxis (US/EU)
Prophylactic treatment of migraine is mainly considered for chronic migraine patients or those with episodic migraine who have long-lasting attacks or do not experience sufficient relief with acute therapies alone. Most of the branded prophylactic treatments for migraine such as the CGRP-targeted therapies showed efficacy largely comparable to that of generic drugs in cross-trial comparisons, although they have proven efficacious in later lines of therapy after patients fail first-line generic options. In addition, most patients only partially respond to these therapies and fail to experience complete pain relief and will, therefore, often rely on acute drugs for breakthrough attacks. Need exists for prophylactic therapies that are more efficacious and tolerable and that target refractory pain. Our content provides quantitative insights into key treatment drivers and goals and the current level of unmet need, based on the perceptions of U.S. and European neurologists. In this report, we analyze the commercial opportunities in the prophylactic treatment of migraine and how emerging therapies can capitalize on these opportunities.
QUESTIONS ANSWERED
- What are the treatment drivers and goals for migraine prophylaxis?
- Which drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
- How do current therapies perform on key treatment drivers and goals for migraine prophylaxis?
- What are the prevailing areas of unmet need and opportunity in migraine prophylaxis?
- What trade-offs across different clinical attributes and price are acceptable to U.S. and European neurologists for a hypothetical new drug for the prophylactic treatment of migraine?
PRODUCT DESCRIPTION
Provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.
Markets covered: United States, France, Germany, United Kingdom
Primary research: Survey of 61 U.S. and 31 European neurologists fielded in December 2022
Key companies: Eli Lilly, Teva, AbbVie, Amgen / Novartis, and Pfizer
Key drugs: Aimovig, Emgality, Ajovy, Botox, Nurtec ODT, and Qulipta
Table of contents
- Migraine - Unmet Need - Detailed, Expanded Analysis: Migraine Prophylaxis (US/EU)
- Executive summary
- Unmet Need - Migraine Prophylaxis - Executive Summary - March 2023
- Introduction
- Overview
- Methodology
- Rationale for treatment drivers and goals selection
- Rationale for drug selection
- Products for the prophylactic treatment of migraine and rationale for drug selection
- Treatment drivers and goals
- Key findings: attribute importance
- Relative importance of efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to surveyed neurologists' prescribing decisions in migraine prophylaxis
- Importance of efficacy attributes to prescribing decisions in migraine prophylaxis: United States
- Importance of efficacy attributes to prescribing decisions in migraine prophylaxis: Europe
- Importance of safety and tolerability attributes to prescribing decisions in migraine prophylaxis: United States
- Importance of safety and tolerability attributes to prescribing decisions in migraine prophylaxis: Europe
- Importance of convenience of administration attributes to prescribing decisions in migraine prophylaxis: United States
- Importance of convenience of administration attributes to prescribing decisions in migraine prophylaxis: Europe
- Importance of nonclinical factors to prescribing decisions in migraine prophylaxis: United States
- Importance of nonclinical factors to prescribing decisions in migraine prophylaxis: Europe
- Key findings: stated vs. derived importance
- Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in migraine prophylaxis: United States
- Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in migraine prophylaxis: Europe
- Product performance against treatment drivers and goals
- Key findings
- Overall performance of key therapies for migraine prophylaxis: United States
- Overall performance of key therapies for migraine prophylaxis: Europe
- Mean overall performance of key therapies for migraine prophylaxis: United States and Europe
- Relative performance of key therapies for migraine prophylaxis across select efficacy attributes: United States
- Relative performance of key therapies for migraine prophylaxis across select efficacy attributes: Europe
- Relative performance of key therapies for migraine prophylaxis across select safety and tolerability attributes: United States
- Relative performance of key therapies for migraine prophylaxis across select safety and tolerability attributes: Europe
- Relative performance of key therapies for migraine prophylaxis across select convenience of administration attributes: United States
- Relative performance of key therapies for migraine prophylaxis across select convenience of administration attributes: Europe
- Relative performance of key therapies for migraine prophylaxis across select nonclinical attributes: United States
- Relative performance of key therapies for migraine prophylaxis across select nonclinical attributes: Europe
- Assessment of unmet need
- Key findings: unmet need in migraine prophylaxis
- Surveyed neurologistsu2019 satisfaction with the performance of key therapies for migraine prophylaxis on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: United States
- Surveyed neurologistsu2019 satisfaction with the performance of key therapies for migraine prophylaxis on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: Europe
- Surveyed neurologists' ascribed level of unmet need across key efficacy attributes in migraine prophylaxis: United States
- Surveyed neurologists' ascribed level of unmet need across key efficacy attributes in migraine prophylaxis: Europe
- Surveyed neurologists' ascribed level of unmet need across key safety and tolerability attributes in migraine prophylaxis: United States
- Surveyed neurologists' ascribed level of unmet need across key safety and tolerability attributes in migraine prophylaxis: Europe
- Surveyed neurologists' ascribed level of unmet need across key convenience of administration attributes in migraine prophylaxis: United States
- Surveyed neurologists' ascribed level of unmet need across key convenience of administration attributes in migraine prophylaxis: Europe
- Surveyed neurologists' ascribed level of unmet need across key nonclinical factors in migraine prophylaxis: United States
- Surveyed neurologists' ascribed level of unmet need across key nonclinical factors in migraine prophylaxis: Europe
- Key findings: unmet need in migraine prophylaxis and related indications
- Surveyed neurologists' ascribed level of unmet need in migraine prophylaxis and related indications: United States
- Surveyed neurologists' ascribed level of unmet need in migraine prophylaxis and related indications: Europe
- Opportunity analysis
- Areas of opportunity in the migraine prophylaxis market and emerging therapy insights
- Opportunity: a prophylactic therapy with a greater patient response rate
- Opportunity: a prophylactic therapy that reduces migraine patients' disability over the long term
- Areas of opportunity in the migraine prophylaxis market and emerging therapy insights
- Target product profiles
- Assessing drug development opportunities
- Target product profile methodology
- Attributes and attribute levels
- Attributes of key current and late-phase emerging therapies for migraine prophylaxis
- Attribute importance and part-worth utilities
- Migraine prophylaxis target product profile: attribute importance
- Reduction in monthly migraine days (placebo-adjusted)
- Response rate (% of patients with a 50% reduction in migraine days/month; placebo-adjusted)
- Reduction in intake/month of migraine-specific acute pain medication (e.g., triptans)
- Reduction in disability (Migraine Disability Assessment Scale; placebo-adjusted)
- Tolerability (% of patients experiencing injection-site reactions; placebo-adjusted)
- Delivery burden (i.e., dosing formulation and frequency)
- Price/treated day
- Conjoint analysis-based simulation of a market scenario
- Migraine prophylaxis market simulation: share of preference of target product profiles included in the market scenario
- Migraine prophylaxis market simulation: likelihood to prescribe of target product profiles included in the market scenario
- Migraine prophylaxis market simulation: target product profiles included in the market scenario
- Appendix
- Key abbreviations
- Bibliography
- Executive summary
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.