With dual approvals, Biohaven's migraine blockbuster-in-waiting snares nearly $500M in 2021

Biohaven has amassed more than 1,375,000 Nurtec prescriptions since the drug’s launch. (AsiaVision/Getty Images)

Armed with dual approvals in migraine treatment and prevention, Biohaven Pharmaceuticals’ blockbuster-in-waiting Nurtec ODT continued to roll in 2021, ginning up nearly $500 million in revenue.

Nurtec ODT, also known as rimegepant, has clinched $190 million in preliminary revenue for 2021’s fourth quarter, Biohaven said Thursday. For the entire year, the drug tallied $462 million in preliminary sales. The company based its estimates on early and unaudited information, and the final results could differ.

The migraine prevention field is already crowded by the likes of Amgen’s Aimovig, Eli Lilly’s Emgality and Teva Pharamceuticals’ Ajovy—but those drugs are injectable, while Nurtec comes in a pill that patients can take up to once a day. Biohaven’s drug in May became the first option approved to both prevent and treat migraines.

That convenience edge has certainly played in Nurtec’s favor. The drug has maintained its hold as the top prescribed med among all new oral migraine therapies, Biohaven said in its Thursday release. Meanwhile, the company has amassed more than 1,375,000 prescriptions since the launch.

Biohaven isn’t the only one buzzing about its dual-acting migraine med, either. Survey work among neurologists and physicians shows a “significant growing trajectory” for Nurtec in both treatment and prevention, Piper Sandler analyst Christopher Raymond wrote in a note to clients Thursday.

In a note to clients titled "Nurtec Juggernaut Continues Unabated," Raymond said his team expects the drug to gin up $845 million in full-year 2022 revenue, slightly above the consensus forecast of $825 million. The drug could break into blockbuster territory in 2023 with sales of $1.38 billion, the Piper Sandler team figures, with that number rising to a predicted $1.85 billion in 2024.

Consensus estimates put Nurtec’s 2023 and 2024 sales estimates slightly lower at about $1.28 billion and $1.78 billion, respectively.

RELATED: Biohaven taps Pfizer for global Nurtec push in deal worth up to $1.24B

Nurtec first passed muster with the FDA in early 2020 with an approval to provide migraine patients with immediate pain relief. In May, the drug snared a green light for preventive treatment in people who experience episodic migraines, or fewer than 15 days of headaches per month.

The company is operating in an increasingly competitive migraine market. AbbVie recently won approval on its own oral migraine preventative called Qulipta, while Eli Lilly has elected to pit its injectable CGRP drug Emgality against Nurtec ODT in a phase 4 prevention trial.

Most drugmakers have yet to report fourth-quarter earnings for 2021. Taking a look at Q3, however, it's apparent that Nurtec's momentum is building. The drug ginned up $136 million in the third quarter, marking a 42% increase over Q2, Biohaven reported in November. 

RELATED: Biohaven's Nurtec ODT outmuscles AbbVie's Ubrelvy in gaining new migraine patients following key FDA nod

For comparison, Eli Lilly's Emgality snared $140 million during the third quarter. Amgen's Aimovig brought in $79 million worldwide for the quarter. And Teva's Ajovy snagged $46 million in U.S. sales.

AbbVie has yet to report sales on its new migraine prevention pill Qulipta, but the drug seems to pose the biggest threat to injectable CGRPs, rather than Nurtec, Piper Sandler's Raymond wrote to clients last year. Doctors polled by Raymond's team and Spherix Global Insights said they didn't expect Qulipta’s launch to eat into Nurtec’s share, but instead to erode share from injectable CGRPs and other generic medicines, Raymond wrote to clients last year.