AIMOVIGTM - New Biologic for the Treatment of Migraine

Drug Review: Volume 19, Issue 2 - Download PDF

Migraine is a very common, long term neurological disorder that affects approximately 8.3% of Canadians, especially women and the working population.  Migraine pain and associated symptoms can be quite debilitating and can last for several hours to days, thus severely affecting productivity and quality of life.  Migraines can be categorized as episodic migraines (EM), <15 headaches per month or chronic migraines (CM), ≥15 headaches per month with at least eight days being migraine days.

Current standard of therapy starts with acute treatment of EM and CM, including analgesics (such as Tylenol® or Aspirin®), anti-inflammatories (such as Advil® or Aleve®) and prescription drugs (such as Imitrex or Zomig®).  Unfortunately, a significant proportion of migraine sufferers continue to experience multiple attacks every month.  Preventative therapies are used to decrease the number of migraines experienced in order to improve quality of life.  However, existing therapies are often associated with many side effects and are not always successful.  Typically, those with CM who fail on these options will progress to treatment with Botox, which involves 31 to 39 injections in the face, head and neck every three months, with an average treatment cost of $2,856 per year.

Aimovig is a first in class agent that specifically targets a signaling pathway associated with migraines and is indicated for treatment of both EM and CM.  In clinical trials, Aimovig was shown to significantly reduce the number of migraines per month and the number of days requiring acute treatment of migraines.

These results were particularly pronounced in the difficult-to-treat subgroup of patients who had failed two or more prior preventative treatments. The result seen in this subgroup of patients was a ≥50% reduction in monthly migraine. 

Adverse effects are generally mild to moderate in severity and include constipation, injection site pain, muscle spasms and general itchiness.

Aimovig has been shown to be very effective in the treatment of refractory migraines, especially in those who have failed on two or more prior preventative treatments.  It is also easily self-administered at home with monthly injections, and is better tolerated than other preventative options for migraines.  However, due to its high annual cost of $6,384 relative to its alternatives, Aimovig will be placed under Special Authorization for ClaimSecure groups subscribing to Managed Formularies.  The Special Authorization process ensures that Aimovig is reserved for members who have already tried and failed alternative preventative therapies.

Drug Name

Aimovig™

Drug Ingredients

Erenumab

Annual Cost

$6,384

Coverage Details

Special Authorization

ClaimSecure Inc. reserves the right to amend in part, or in its entirety, its Special Authorization guidelines.

References:

1) Aimovig Product Monograph.  Novartis Pharmaceuticals Canada Inc,, August 2018.  Available at: http://www.ask.novartispharma.ca/download.htm?res=aimovig_scrip_e.pdf&resTitleId=1480

2) Health Reports. Prevalence of migraine in the Canadian household population [Internet]. 2015; http://www.statcan.gc.ca/pub/82-003-x/2014006/article/14033-eng.htm. Accessed 2019 Jan 3.