Eli Lilly hit by migraine drug launch slowdown and a Reyvow no-show, but rivals Biohaven, AbbVie post sales boost

As the dust settles around pharma’s second-quarter financial readouts, we check in on how the new and increasingly crowded migraine market is looking.

Eli Lilly had some of the most disappointing sales figures in Q2 for its migraine prevention drug Emgality, FDA-approved four years ago, which saw sales hit $157.5 million, an increase of just 1% compared to the year-ago period.

The drop was from the U.S., where sales were just $108.6 million, down 3% on 2021’s numbers. This was driven by “lower realized prices” due to higher contracted rebates and an “unfavorable segment mix,” Lilly said in its financial statement.

But there was some good news. The decline was “largely offset by increased demand,” Lilly found when combing through the numbers, and revenue outside the U.S. was $48.9 million, up 11%.  

Lilly’s other migraine treatment Reyvow was absent from its “select products” list in its Q2 review. Since its 2019 approval, the drug has suffered from weak sales amid side effects concerns.

In the first quarter of the year, all eyes were on the emerging battle between AbbVie and Biohaven, a David and Goliath match-up of two new companies trying to dominate a highly competitive market.

In Q1, both were hit by weak sales. AbbVie’s oral CGRP inhibitor Ubrelvy, approved to treat migraine in late 2019, brought $138 million sales in the first quarter, which missed Wall Street’s expectations by 18% and marked a 25% decline from the fourth quarter of 2021.

And AbbVie's newly launched Qulipta, green lit in September 2021 to prevent migraine, generated $11 million in its market debut, but analysts had anticipated $20 million.

When AbbVie posted its numbers, Biohaven’s stock price dropped because the pharma’s numbers suggested the entire class is facing pricing pressure.

In the end, Biohaven reeled in $123.6 million for its migraine treatment and prevention drug, Nurtec, a major 35% decrease from Q4, which the company said was “largely driven by seasonality related to renewed patient deductibles and prescription reauthorization.”

That news was mostly forgotten in the noise of a buyout from partner Pfizer, which snapped up the company predominately for Nurtec. The migraine med was first approved in early 2020.

The second quarter was far kinder to its numbers: Nurtec saw $194 million in sales, a 109% increase over the second quarter of 2021 and a 57% increase from Q1.

Biohaven said in its financials that this was “due primarily to increased Nurtec prescription sales volume” and “favorable pack mix per prescription.” 

AbbVie, meanwhile, posted sales of $185 million for Ubrelvy, up 48% on last year, while Qulipta ticked up to make $33 million.

AbbVie will now have to battle against the marketing might of Pfizer as it subsumes Biohaven into its business, so expect this complex market to only heat up in the future, but both have seemingly shrugged off the Q1 disappointment.

Amgen’s therapy Aimovig, a migraine prevention drug that like Lilly’s Emgality has been on the market since 2018, also saw some good news with sales up 12% year-over-year for the second quarter, bringing in $92 million. But sales here were primarily driven by higher net selling price but partially offset by an 11% decline in volume and still doing half of the sales Biohaven is bringing in.