On Thursday, the Food and Drug Administration approved the first drug explicitly developed to prevent migraines. But while the drug may signal a new wave of effective treatments for this debilitating — yet often ignored and dismissed — medical condition, there are still questions as to how many migraine sufferers in the US will actually be able to afford it.
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The drug, called Aimovig, was jointly developed by the pharmaceutical companies Amgen and Novartis. It works by using antibodies to block the effect of a protein molecule that plays a key role in triggering and sustaining migraines, known as calcitonin gene-related peptide, or CGRP.
In the three Phase III clinical trials that sealed the drug's approval, people treated with Aimovig were found to experience anywhere from one to two-and-a-half fewer days of migraines per month than a placebo group, with no added side effects.
"The drugs will have a huge impact," Amaal Starling, a migraine specialist at the Mayo Clinic in Phoenix, told The New York Times. "This is really an amazing time for my patient population and for general neurologists treating patients with migraine."
Migraines, which are markedly more painful and last longer than a headache, are estimated to regularly affect more than 10 per cent of the population, according to the FDA. Women are three times more likely than men to have migraines, and poor, elderly and disabled people also experience them more often. The causes of migraines remain unclear, but for some people, there seem to be consistent environmental triggers, like certain foods or stress.
Over-the-counter painkillers like ibuprofen can help alleviate migraines somewhat, as can off-label prescription medications that constrict blood flow in the brain, or treatments like Botox that freeze the nerve endings thought to cause pain. But these more extensive treatments only sometimes work for a minority of sufferers and they have their own side effects. Over-the-counter medications even sometimes worsen the severity of migraines the longer they're used.
Because the new drug's antibodies remain in the body for a while, patients only need to take Aimovig once a month, via injection. Other antibody-based drugs in the works may require even less upkeep. But, as with many new drugs, people may have to pay a steep price to get ahold of Aimovig.
The list price of Aimovig is expected to be $US6900 ($9177) a year. Much of this cost might presumably be covered by insurance plans in the States, but as a reporter for Splinter has detailed before, migraine sufferers often have a hard time obtaining coverage for their treatments.
And historically, many have had trouble even getting their migraines recognised as a legitimate medical condition by their employers or welfare programs. Whether that reality will change with the availability of drugs directly marketed for migraines remains to be seen.