On January 23, 2020 the ICER review board met in a public meeting, along with doctors and patient advocates to determine the efficacy and availability of the newest class of migraine medications. There was much testimony given about the patient trials and results of those. Concurrently, there was testimony given about prescriber limits and cost of the new migraine medications.
The three new medications that were included in these discussions were Lasmiditan (Reyvow TM), Rimegepant and Ubrogepant (Ubrelvy TM), these new medications are for the acute treatment of migraine. Key clinical outcomes, from the trials, were presented. Even though in clinical trials, the perfect patient candidates were selected, the results were mostly positive vs placebo at the two hour mark. Most of the data for these medications come from single migraine attacks in trials. The repeated use of these medications are not certain as well as quality of life, work and productivity are unknown at this time. It seems to be thought that repeated use over time may decrease the frequency of migraine attacks. Also, these medications in trial seem to have few side effects.
Having new medication options is important to all people with migraine. This was stressed to the review panel in patient testimonies. With migraine being the second cause for disability, we deserve these options so that we may become contributing members of society again.
The outcome of the ICER review panel was a unanimous vote in support of the health benefit of these new gepants & one ditan. Also, the majority voted that they agree that intermediate long term value with the current pricing. Both of these points are hopeful for the migraine community.
CHAMP (Coalition for Headache and Migraine Patients) has expressed concerns regarding the possible prescriber restricions. This could cause people to have complications with access to these medications. CHAMP is also concerned about the differences in money between ICER’s findings and the side analysis.
As these new medications come to the market, hopefully the standard of care for migraine patients changes and allows for these new drugs to be readily accessed. We, the migraine community, deserve these new medications to be available to us. The potential increase in quality of life and reduction of pain is something to get very excited about and we hope that the insurance providers agree to help us achieve this.