U.S. cost watchdog ICER has routinely run into industry pushback for its conclusions that many new launches are too pricey, and sometimes, it changes its tune. While the group previously concluded new migraine drugs from Eli Lilly, Allergan and Biohaven offer questionable benefits over older medicines, ICER issued more favorable findings for two of those drugs after another look at the data.
In its final report on new migraine therapies, ICER concluded that Allergan’s Ubrelvy and Biohaven’s unapproved rimegepant offer more benefits than it previously realized. The new findings support "a near doubling of ICER’s health-benefit price benchmark for these two treatments,” chief medical officer David Rind said in a statement.
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The group calculated a price benchmark of $4,200 to $4,600 for the Allergan and Biohaven medicines, slightly lower than Ubrelvy’s annual list price of $4,896. Biohaven’s drug hasn’t scored an approval, so it doesn't yet have a list price.
For Eli Lilly’s Reyvow, ICER’s price benchmark came in at $2,800 to $3,200 compared with the med’s list price of $4,610 per year, suggesting that the drug needs a hefty discount.
Biohaven is "gratified that ICER has reassessed the data" and issued its updated finding, CEO Vlad Coric said in a statement.
"We feel vindicated by this decision, which confirms our long-held assertion that rimegepant provides several important differentiations from currently available treatments, including triptans," he added.
ICER reached the new conclusion after working with Allergan “to identify high-quality evidence demonstrating additional clinical benefits ... beyond the two-hour time point required by the FDA for the clinical trials,” Rind said in the statement. Those data were specific to Ubrelvy, but ICER believes they apply to Biohaven’s forthcoming option, as well.
Overall, data supporting the new meds don’t indicate they are better than older triptans, ICER found. Clinical experts, patient advocates and even the drugmakers agreed that it’s “reasonable” to require patients to try triptans first if they are eligible. The meds do provide benefits compared with no treatment, the experts found.
After ICER put out a draft version of the report last November, Biohaven CEO Vlad Coric told FiercePharma that more than 4 million migraine patients don’t respond to triptans or can’t take those medicines because of cardiovascular risks. A new option "clearly will be an important addition to these patients,” he added.
ICER typically releases evidence reports on drugs around launch time to inform stakeholders about new meds, VP of communications and outreach David Whitrap previously told FiercePharma. The group has had a contentious history with drugmakers, but recently, relations have been improving and more companies are participating in the review process, he added.