The National Institute for Health and Care Excellence (NICE) has published the outcome of an appeal against its final draft guidance for Novartis’ Aimovig (erenumab) – a drug indicated to prevent chronic migraine.

In September last year, NICE published final draft guidance confirming its earlier position not to recommend the drug for preventing chronic and episodic migraine in adults who have four episodes or more of migraine every month.

The independent appeal panel’s rebuttal was that the committee unreasonably failed to consider the cost-effectiveness of the drug in comparison tobest supportive care. As a result, the appraisal committee has now been asked to request any available data to enable it to consider the role of Aimovig when it is used at this point in the treatment pathway.

The appeal panel says that it considered that, in view of the clear evidence from experts, this was a “plausible clinical use of the drug” and it was unreasonable for the appraisal committee not to have considered any relevant data regarding the effectiveness of Aimovig following botulinum toxin therapy.

NICE initially rejected NHS funding for the monoclonal antibody in January last year, deeming it “too costly” for the service.

If approved, the drug would offer patients a novel therapeutic approach as the first treatment to block the calcitonin gene-related peptide receptor (CGRP-R), which is thought to play a critical role in migraine.

It is estimated that there are 190,000 migraine attacks experienced every day in England with women more likely to experience one than men (5-25% versus 2-10% respectively).