Draft ICER Report Questions Cost-Effectiveness of New Migraine Drugs

Analysis of soon-to-be-launched migraine medicines questioned over performance and price.

The Institute for Clinical and Economic Review has published a draft report on the cost-effectiveness of three new migraine drugs that are soon to be launched. The news is reasonably good for patients that cannot take or haven’t responded to triptans – the conventional medications used for migraine therapy. For these people, Eli Lilly’s Reyvow, Allergan’s ubrogepant and Biohaven’s rimegepant provide a “small or substantial” health benefits with “moderate certainty.”

For patients already taking triptans, however, ICER found that ubrogepant and rimegepant are “comparable or inferior”, while Reyvow is expected to offer lower efficacy.

One unaddressed variable is the pricing for these drugs, which hasn’t been established yet and does factor into the equation. ICER used expected pricing numbers in its evaluation and found that triptans would “provide a greater benefit at a lower total cost” for patients who respond to them.

There are, however, a significant number of migraine sufferers who can’t take or do not respond to triptans, and for them, having other options will be beneficial. Some of the drugs were tested against standard medications in clinical trials and shown to perform well, potentially calling into question ICER’s evaluation approach.


David Alvaro, Ph.D.

David is Scientific Editor in Chief of the Pharma’s Almanac content enterprise, responsible for directing and generating industry, scientific and research-based content, including client-owned strategic content, in addition to serving as Scientific Research Director for That's Nice. Before joining That’s Nice, David served as a scientific editor for the multidisciplinary scientific journal Annals of the New York Academy of Sciences. He received a B.A. in Biology from New York University in 1999 and a Ph.D. in Genetics and Development from Columbia University in 2008.