Physician Views: Armed with new data, migraine therapy Aimovig nears market

Later this month, the FDA is expected to approve Amgen and Novartis' Aimovig, a potential first-in-class CGRP inhibitor for the prevention of migraine.

The potential cost of these therapies has recently made the news, but price alone will not determine their commercial success; to get a better idea of how ready physicians are for Aimovig, we are snap-polling US and EU5 neurologists (in collaboration with Medefield MedePolls) with the following questions…

Regulators in the US and EU are currently reviewing Aimovig (erenumab), an investigational treatment designed for the prevention of migraine in patients experiencing four or more migraine days per month. If approved, Aimovig is expected to be the first and only fully human monoclonal antibody targeting the calcitonin gene-related peptide (CGRP) receptor, specifically designed for the prevention of migraine. If approved, it will be administered once-monthly using a self-injection device.

Based on your existing awareness of Aimovig and its clinical data, how frequently do you plan to prescribe it in the initial 12 months following its (potential) approval?

I don’t plan to prescribe

Infrequently

Frequently

Very frequently

How would you describe the level of unmet need for Aimovig prior to its approval?

None

Minimal

Moderate

Significant

Amgen and Novartis recently presented new data from the 246-patient Phase III LIBERTY trial, showing that Aimovig reduced migraine frequency by at least 50 percent in 30.3 percent of patients, versus 13.7 percent of placebo-treated patients. The study enrolled patients with episodic migraines who had previously failed between two and four preventative treatments. They were treated over a 12-week period with decline in monthly migraine days versus baseline measured in the last four weeks of treatment.

Will these newest clinical data make you prescribe Aimovig more than you previously anticipated?

No

No - These data will make me prescribe Aimovig (erenumab) less frequently than anticipated

Yes - moderately more

Yes - significantly more

Which of the following factors (please select one) will act as the biggest initial barrier to real-world utilisation of Aimovig and other CGRP inhibitors?

Cost/payer resistance

Lack of compelling clinical data

Lack of underlying demand

Difficulty in identifying relevant patients

Patient apathy to injectable migraine treatment

Other (please state)

Teva is developing another CGRP inhibitor (fremanezumab), which is also under review in the US and EU for the prevention of episodic and chronic migraines. Fremanezumab is a quarterly or monthly injection that may be administered by a healthcare professional, or self-administered by the patient.

Assuming real-world efficacy is comparable across different CGRP inhibitors and dosing schedules, do you think potential quarterly dosing of fremanezumab will provide a significant commercial advantage over once-monthly treatment?

No

Potentially - but other factors such as administering a lot of drug at once will need to be considered

Yes

Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions. Note: FirstWord Polls are powered by Medefield MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at info@firstwordpharma.com.

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