These drugs may cost you anywhere between $8,000 and $24,000 a year.
Anyone who get migraine attacks-about 53 million Americans and millions more around the world- can easily tell you how awful they are. Many people don’t know much about intensity of migraine attacks and they feel experience is quite similar to headaches-after all everyone has headaches at some point, right? And because existing treatments don’t work, migraines can greatly affect your professional and social life. That why I was really happy and excited when I first heard about these new class of drugs that are currently being developed specifically to prevent migraines.
These drugs are currently being developed by four pharmaceutical firms in the United States and they may get all regulatory approvals by 2019. These drugs can neutralize the activity of chemical which is used by body’s nerve cells to transmit various pain signals to the brain when migraine occurs. They seem to be working in a much better way than other preventive treatments-without too many side effects. However, these drugs will make a big hole in your pocket as they may cost thousands of dollars every year, raising big concerns about who all can really afford them.
“So far, these drugs look promising in clinical trials, their results are good, the safety studies are also satisfactory, and hopefully they will surely come to market,” says Deborah a neurology professor at University of Texas Southwestern Medical Center. “But I feel the cost of these drugs can be a big bottleneck which may limit them to only few sufferers who can afford them”
As most of the existing migraine treatments on the market are hit-and-miss, it’s no wonder new drugs excite many. “These nerve drugs may finally help prevent migraine attacks,” Scientific American wrote in a report in January 2016. “Can antibodies finally disrupt migraine attacks and put an end to sufferings of millions?” asked Science in January. Dodick who has been in touch with many firms developing these drugs, says they could be no less than a revolution for migraine sufferers. “Here millions of lives could be affected and so much is at stake. I see so many migraine patients whose lives have been wrecked by this awful disease,”Dodick says. “The current excitement is beyond words.”
The new drugs are in the form of injections of special lab-made molecules known as monoclonal antibodies. They have ability to block functioning of small proteins (CGRP) that widen blood vessels and also help in the transmission of pain signals throughout the body. This protein is known to play a vital role in migraines for than 30 years.
The four pharmaceutical firms developing these migraine drugs-Amgen, Alder BioPharmaceuticals, Teva, and Eli Lilly- are trying to test slightly different antibodies that are administered to people at different times. (Allergan is also in a process of developing a CGRP neutralizing drug; it’s actually a pill and not injections). Some are testing injections every three months, while others are testing monthly injections. Most of these companies have completed phase 2 clinical trials and are now conducting phase 3 trials. Last rounds of testing are mandatory for FDA approval. So far the test results look promising. The patients who had up to 15 migraines a month before they were admitted to the study started experiencing less than half after a year of injections. This means who had 15 migraines a month got one full week of their life back. And for lucky few in these trials, their migraine attacks disappeared completely.
These drugs are actually monoclonal antibodies (they are made from living cells), so they are expensive to produce, and have a hefty price tag. In fact, monoclonal antibodies are currently some of the priciest drugs on the market. For example, Alexion’s Soliris that treats a rare immune disorder has been dubbed as the world’s most expensive drug costing $400,000 a year.
How expensive will these migraine drugs be?
Well, they can range from $8,000 to $24,000 a year. Only Rndy Schatzman, Alder BioPharma CEO is willing to discuss the price. Alder is closely following another class of antibodies used to lower cholesterol levels. These antibodies cost $15,000 when they come out. One thing is clear “There’s lot of money to be made.”
If price of these drugs is high, then most health insurance companies will try to restrict access to these antibodies, just like they do for widely popular Allergan’s Botox, migraine specialists and analysts say. Botox is the only FDA approved botulinum toxin to treat people with 15 or more migraines a month, and is one of the most expensive migraine treatments. A Botox vial can cost around $1,200. Patients may need four vials a year and are also charged the injection fees. So Botox treatment for migraines may cost anywhere between $5,000 and $10,000 a year. All those patients who have no secondary insurance, the out-of-pocket cost can be around $1,400, according to Deanne Grossman, who is head of Headache Center at Jefferson University. This steep price can climb even higher if patient needs higher dosage. The result-only one percent of migraine sufferers in the US are treated with Botox, according to Mike Getting of the New York Headache Center.
As Botox is so expensive, most health insurance companies require patients to try and fail at least two or more Botox treatments before they are allowed to receive injections. Most of the migraine analysts and specialist think that new monoclonal antibodies that will be used for treating migraines will be similarly restricted. Stephen Sebastein, a director of the Jefferson Headache Center, and professor of neurology at famous Thomas Jefferson University, who’s studied migraines for around 25 years , said he wouldn’t be surprised if most insurance companies required migraine patients to first fail Botox before accessing more expensive antibodies. This can be very expensive proposition for patients and also adds another layer of restrictions, especially for all those with limited income as compared to their rich counterparts.
Monoclonal antibodies hold a great promise for migraine patients but price can be a big disappointment-at least for those who don’t have money or cannot take the treatment due to hurdles put forth by their insurance companies.