Lilly launches migraine med Reyvow at $640 per eight-pill pack

Eli Lilly has launched its new acute migraine medicine Reyvow, following the successful completion of a Drug Enforcement Administration review. 

Although Reyvow (lasmiditan) was approved by the US Food and Drug Administration last October for the treatment of acute migraine, the DEA then had to review the drug as it affects the central nervous system.

Now the DEA has deemed Reyvow as having a low potential for abuse or dependence, Lilly is free to market the drug in an increasingly competitive market. The pharma giant has priced the drug at $640 per eight-pill pack, although the list price of the drug is not necessarily what patients will actually pay.

Depending on the duration of treatment and an individual’s healthcare plan, out-of-pocket costs can vary widely.

Lilly said it will offer a ‘Reyvow Savings Card’ for eligible patients to help them access the drug, by aiding with out-of-pocket costs.

Although triptan medications are widely recommended for acute migraine treatment, Lilly said that from a survey of migraine patients, 79% were willing to try another acute treatment.

“Lilly has devoted 25 years to researching disabling neurologic diseases. With new science comes new hope and new expectations,” said Patrik Jonsson, senior vice president, Eli Lilly and Company and president, Lilly Bio-Medicines.

“We are proud that with a single dose of Reyvow, people living with migraine have a chance for rapid and complete elimination of pain and their most bothersome symptom in two short hours. Everyone deserves freedom from the pain and symptoms of this crippling disease,” he added.

Lilly’s other migraine med – CGRP antagonist Emgality (galcanezumab) – has begun to establish itself in the prevention category, but still lags behind first-in-class Aimovig (erenumab) from Novartis and Teva’s second-to-market Ajovy (fremanezumab).

Evaluate Pharma forecasts Aimovig to maintain its lead up to 2024, with estimated sales of $2.05bn that year. It also predicts Emgality could hit $1.2bn by 2024, with Ajovy forecast to reach $962m.

Emgality could make further gains after it won the race to claim the first approval of a drug in the class for cluster headache. It was not only the first CGRP inhibitor drug to be approved for the condition, but also the first drug backed by the FDA that reduces the frequency of attacks in cluster headache patients.

Unlike these antibody-based CGRP inhibitors, which have been approved for migraine prevention and are administered intravenously, Reyvow offers an option for treating attacks once they have already begun.

It is also a first-in-class drug – it is an oral treatment, which binds to the 5-HT1F receptors believed to play a role in the onset of migraine.

In clinical trials, 28%-39% of patients on Reyvow treatment achieved complete relief from migraine pain after two hours, compared to 15% and 21% in the placebo arm.

In addition to the complete relief response, 41%-49% of patients achieved freedom from their most bothersome symptom at two hours with Reyvow treatment compared to 30%-33% on placebo.

Its closest competitor is Allergan’s Ubrelvy (ubrogepant) – an oral CGRP inhibitor which also has FDA approval in the treatment of acute migraine, with or without aura.

Analysts have suggested that Allergan’s oral CGRP franchise – which also includes another candidate in late-stage development for migraine prevention – could go on to generate blockbuster sales.