Amgen may have the first-mover advantage in the new class of CGRP migraine prevention drugs, but the company didn't get top billing with one major pharmacy benefits manager. CVS gave that to Teva and Eli Lilly instead.
For its commercial formulary, CVS Caremark sidelined Aimovig, which Amgen sells in partnership with Novartis, in favor of rival drugs from Teva and Eli Lilly, a spokeswoman said via email.
Patients who want to take Lilly's Emgality or Teva's Ajovy will still have to try other migraine prevention options first, but the drugs' preferred status will give them a boost as they vie for market share in the budding field.
It's a setback for Aimovig, which beat its rivals to market with its approval last May and has so far enjoyed a surge of demand. While sales haven’t yet taken off, Credit Suisse analyst Vamil Divan wrote in July that the company was “overwhelmed” with early interest after speaking with a Yale University migraine specialist.
Amgen and Novartis are "disappointed CVS chose to include Aimovig as a non-preferred agent on CVS national template formularies," an Amgen spokeswoman said via email.
The partners "believe in the importance of [healthcare practitioner] choice," she added. "We will continue to work towards achieving choice for HCPs and patients, by inclusion of Aimovig as a preferred brand in all formularies at CVS."
CVS' PBM outfit covers 93 million people in the U.S., according to the company's corporate website.
The decision follows a move by rival PBM Express Scripts to favor Amgen and Eli Lilly CGRP options over Teva’s Ajovy. But on Friday, Reuters reported that Express Scripts recently changed Ajovy’s status so that it may appear on some coverage lists, but will likely carry a higher co-pay than its rivals.
While each company faces different challenges, the launches are important for all three. All of the drugs carry a $6,900 list price per year, which U.S. cost watchdog ICER endorsed after market watchers warned against higher pricing in the field. After Amgen's May approval, Teva and Eli Lilly followed with FDA nods in September.