A new medicine for migraines

NICK EICHER, HOST: It’s Thursday, the 31st of May, 2018.

Glad to have you along for today’s episode of The World and Everything in It. Good morning, I’m Nick Eicher.

MARY REICHARD, HOST: And I’m Mary Reichard.  

The Food and Drug Administration this month approved a new drug that prevents migraine headaches. This is welcome news for the millions who suffer debilitating headaches accompanied by intense throbbing pain, and often nausea, vomiting, and sensitivity to light and sound. Women are affected by migraines three times more often than are men, and recurring attacks are common. But help may be on the way.

On the line to talk about it is Dr. Charles Horton, who reports on medical matters for us at WORLD. Dr. Horton, tell us about this new drug Aimovig and how it’s used and the cost?  

CHARLES HORTON, GUEST: Aimovig or erenumab, to say its generic name, is a CGMP receptor blocker. That’s a fancy way of saying it’s an entirely new class. CGMP is calcitonin gene-related peptide and blocking this receptor is a whole new approach to treating migraines. It’s actually given by self-injection. If you’ve known anyone who takes drugs like insulin, some blood-thinners like Lovanox, those are also given by self-injection. But you only have to do it once a month. The list price is $6,900 per year, which is quite steep, although interestingly not quite as steep as people had feared. Some folks think this is because a couple of blockbuster—theoretically blockbuster—cholesterol drugs that came out not long ago, Repatha and Preluin, listed for $14,000 a year and have actually sold very poorly. It’s thought by a lot of folks in the medical world that they just aimed too high with the price, and these large negotiators, the pharmacy benefit managers just said, “Whoa. Too much.”

REICHARD: Well, I don’t know anybody who could afford to pay that. So what are migraine sufferers to do?

HORTON: Patients with insurance are not going to be paying anything like $6,900 a year. Their co-pay, depending on their specific insurer, may be a lot or may be a little. Angem then states that will have this $5 co-pay program to limit the out-of-pocket co-pay. And, from what I understand of the program, that would apply to a lot of different insurance products. The situation may be somewhat stickier for folks on cost-sharing. Angem states that they have programs to help people find ways to limit the cost of it. I’m hopeful that they’ll do something productive with respect to cost-sharing, but that’s kind of unwritten yet. My advice if you’re on cost-sharing and you need this, contact Angem and tell them about your situation.

Ok. I guess we should mention side effects of this drug for those who manage to acquire it. What do we know about this one?

HORTON:  The most most common one is pain at the injection site. I guess that’s not surprising, if you’re getting poked by a needle. That might hurt. Occasionally someone gets constipation from it. But compared to disabling migraines—and this is certainly a drug aimed at people that have disabling migraines, not an occasional headache, not even an occasional bad headache, but people that are in some cases not having a job or withdrawing from social life because they’re so afraid that they’ll develop a headache. In fairness to Amgen, one reason that they developed a drug that costs so much… It’s — for a minor nuisance one might say, well, you know, if I can get rid of it for $10 or $20, great, but not for a lot of money. For something where their proposal is “we’re giving folks their life back.”

REICHARD: Well, of course this comes as President Trump gave makers of this drug and insurance companies a headache of their own with talk about how unaffordable they are making drugs for Americans, not just this drug.

HORTON: Indeed. And what’s going to be coming up, whether or not this is really related to President Trump’s announcement or not, the drug companies are probably going to end up with substantially lower costs on this class of drugs. But that’s ‘cause of just good old competition. Aimovig is only going to be the only player in this field for likely a couple of months before other products hit the market. And as soon as there’s more than one player, you know what will happen to the prices. Angem probably also is keeping a lid on the prices because they want to grab all the marketshare they can and build loyalty to their product before everybody else gets there.

Dr. Charles Horton is medical correspondent for WORLD. Thank you, Doc!

HORTON: Thank you!

(Amgen Inc. via AP) This May 10, 2018, image provided by Amgen Inc. shows an artist’s rendering of the packaging for the drug Aimovig, the first in a new class of long-acting drugs designed to prevent chronic migraines. 

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