$30 billion migraine drug market: 6 new CGRP drugs in contention.

Migraine is a common trigeminal neurovascular headache, characterized by repeated episodes of light to severe headaches, with individual seizures lasting 4-72 hours, seriously affecting the daily life of patients.
estimate s1.3 billion migraine sufferers worldwide, about one-seven-year-olds in the United States (about 33 million) suffer from migraines, 8 million in Japan and about 13 million in China.
migraines are more common among women, with about three times as many female patients as men.
, migraines are mainly divided into seizure migraines (15 days per month) and chronic migraines (the number of days of headache per month is 15 days).
for clinical purposes, migraines are treated in ways such as emergency treatment in the event of an acute attack, as well as routine preventive treatment to reduce the number of days of seizures.
migraine drugs have been very limited for quite some time, and the use of the tupitan ethnotropics in the 1990s is only a relief for the level of headaches that occur during migraine attacks and does not prevent migraine attacks.
since the quuptamine, no breakthrough migraine drug has been on the market.
April 2014, the FDA approved topropidase to prevent migraine attacks in adolescents.
, due to a large patient population and fewer treatment options, several analysts have forecast the potential market space for migraine drugs at between $30 billion and $40 billion.
With the study of the pathological mechanism of migraine, it was found that the release level of calcitonin gene-related peptides (CGRP) increased significantly during migraine attacks and was positively associated with the degree of headache, thus attempting to relieve headaches and prevent migraine attacks by inhibiting the activity of CGRP extreme receptor CGRPR.
compared to quralmic drugs, targeted inhibition of CGRP/CGRPR is relatively safe for patients with cardiovascular disease.
, CGRP/CGRPR monotag has the characteristics of large molecular weight and long half-life, while small molecule CGRP/CGRPR antagonists metabolize quickly and can be used for acute treatment of migraines.
in recent years, targeted CGRP/CGRPR inhibitors have become the most popular research and development direction for new migraine drugs. According to NextPharma, the global drug database for
Pharmaceutical Srubik,'s next drug database, the FDA has approved seven new migraine drugs since 2018, six of which are CGRP/CGRPR drugs.
analysts noted that the migraine drug market is expected to grow significantly over the next few years, possibly more than $11 billion, driven by CGRP-targeted drugs, while the market size of CGRP drugs is expected to reach $5 billion by 2024.
FDA-approved new migraine drugs (2018-present) from the table above can also summarize some of the characteristics of the currentlisted CGRP/CGRPR class of new drugs, such as: 1) macromolecule monoanticratic CGRP/CGRPR inhibitors are mainly used for preventive use, reduce the number of days of seizures, small molecule SCGRP/CGRPR is mainly used for acute treatment in the event of migraine attacks.
2) Drugs targeting CGRP inhibitors are used to prevent seizures, and drugs that target CGRPR range from seizure prevention to acute treatment.
the current number of CGRP/CGRPR migraine new drugs approved time difference is not much, the difference in market performance is not significant.
but if you consider the market competition, these drugs in the route of administration, dosage is still quite different, see the table below.
the difference between the new drugs listed at CGRP/CGRPR, in addition, in 4 mono-antidrugs, Lingbei Pharmaceutical's eptinezumab because it is intravenous, the risk of adverse reactions at the injection site is lower than that of the subcutaneous injection, and the frequency of administration is 1 time per quarter, with better compliance.
price, the smallest package dating unit price for the first three CGRP/CGRPR monoantinos is close, at about $600/unit, and the annual cost of treatment is about $6,000.
reported that Aimovig, the first approved company, had sales of $127 million in 2018 and $409 million in 2019 and 2019.
Lilly's Emgality sales for 2019 were $162 million, ahead of the earlier listing of Ajovy ($093 million).
AyrGen Ubrelvy is the first SMALL MOLECULE CGRP antagonist approved by the FDA, available in 50 and 100mg sizes, of which 50mg is priced at $84.12 per chip.
Biohaven's Nurtec is the FDA-approved first small molecule CGRPR antagonist, the dosage form is quick-acting tablets, dosage does not need to drink water when taking the drug, patients can take the drug anytime, anywhere, very convenient, the price of the drug is unknown.
, according to Evaluate Pharma, Nurtec's 2024 sales will reach $897 million, above Its forecast of $302 million for Ubrelvy.
note that Lilly has a larger portfolio advantage in the new migraine drug market. In addition to CGRP mono-e-egality,
acquired another migraine drug, Reyvow, in October 2019.
this is a small molecule 5-serotonin 1F (5-HT1F) receptor agonisant, approved two months earlier than Aer Gen Ubrelvy, the first FDA-approved oral migraine drug, and the first FDA-approved 5-HT1F receptor agonisant.
in terms of therapeutic effect, Lilly's Emgality and Reyvow can be used to prevent and treat migraines respectively, with good synergies.
in an increasingly crowded migraine circuit, it would also put Lilly in a relatively competitive position.
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