October 09, 2023
Pfizer and AbbVie oral migraine drugs earn top spots with physicians, survey finds
Oral drugs have raced to the front of the pack in the crowded migraine therapy space and appear to be staying put with physicians.
Primary care physicians in particular are prescribing Pfizer’s Nurtec and AbbVie’s Ubrelvy and Qulipta, according to Spherix Global Insights’ latest quarterly survey of migraine drug prescribers. Primary docs reported more than 27% of patients on Nurtec for acute use and about 20% for preventative care.
Neurologists aren’t far behind, with more than 21% of patients prescribed Nurtec for acute use and around 14 % on preventative therapies.
Meanwhile, the calcitonin gene-related peptide (CGRP) injectables that burst onto the scene in 2018 are hovering between 6% and 10% reported share among both types of physicians, according to Spherix data.
Far from failing, though, the steady-share preventative drugs, including Eli Lilly’s Emgality, Amgen’s Aimovig and Teva’s Ajovy, are still widely used and led the way as game changers in a therapy area that had seen little innovation in almost 30 years.
Nurtec, Ubrelvy and Qulipta are also CGRP antagonists, although they are non-peptide small molecules often referred to as gepants. Ubrelvy (ubrogepant) was approved first in December 2019 for acute care, followed by Nurtec (rimegepant) from Biohaven in February 2020 for acute use and in May 2021 for preventative care. Qulipta (atogepant) was approved in September 2021 for preventative treatment.
The newest gepant, Pfizer’s Zavzpret (zavegepant), approved in March for acute use and administered as a intranasal spray, is already gaining physicians’ attention. Although it was only in pharmacies for about one month before Spherix’s August survey, primary care doctors said 3.9% of patients already are using Zavzpret, while neurologists said 2.3% were using it.
“The doctors we talked to are saying they’re looking forward to, as one doctor referred to it ‘Nurtec spray.’ It’s already tracking higher than some of the others that have been on market a few years,” said Frank Franzino, insights director, neurology at Spherix.
While it will take time to see how Zavzpret interest translates to prescriptions, it seems likely the Pfizer and AbbVie orals will stay among physicians’ preferred set. When Spherix asks doctors to estimate total current prescriptions by brand, the analysts also ask what they expect for the next six months. Nurtec, Ubrelvy and Qulipta all notched higher percentages, ranging from 1% to 5% with both physician groups.
As part of the RealTime Dynamix quarterly surveys, Spherix also asks doctors about patients’ requests for brands. Nurtec was the most requested at primary care visits this quarter, although AbbVie’s Ubrelvy and Qulipta, along with its neurotoxin brand Botox, followed closely behind. Among brand requests from neurologists, Botox led the list, followed by Nurtec, Emgality, Ubrelvy and Qulipta.