Spherix Global Insights

February 08, 2022

Robust Uptake of AbbVie’s Qulipta Turns Up the Pressure for Amgen, Eli Lilly, and Teva in the Prevention Segment of the Migraine Market, Spherix Reports

Needle aversion and oral therapy preference is costing new prescription opportunities for Amgen’s Aimovig, Eli Lilly’s Emgality, and Teva’s Ajovy

EXTON, Pa., February 8, 2022 / PRNewswire/ — The September 2021 approval of Qulipta for the preventive treatment of episodic migraine has added a third asset to AbbVie’s (formerly Allergan’s) migraine portfolio. While most of the early launch buzz is focused on how Qulipta will compete with Nurtec ODT, Biohaven’s first-to-market gepant for prevention, Spherix research suggests that AbbVie’s gepant will further blunt the uptake trajectories for the more-established subcutaneous (SC) calcitonin gene-related peptide (CGRP) antagonists.

The first of six quarterly deep dive reports included in Spherix’s Launch Dynamix™: Qulipta (AbbVie) for Migraine Prevention (US) service collected the responses of 86 U.S. neurologists and migraine specialists three months post launch. Analysis of time-aligned launch benchmarks reveal that Qulipta now sets the bar for high satisfaction among early adopters – displacing Nurtec ODT (for prevention) and Amgen’s Aimovig from their previous perch on top.

Positive clinical experiences with the oral gepants within the prevention segment foretells competitive headwinds for Aimovig, Eli Lilly’s Emgality, and Teva’s Ajovy. In particular, insights included in this first quarterly report suggest that:

  1. Robust projected Qulipta uptake over the next six months – occurring in parallel with continued growth for Nurtec ODT – will put substantial stress on the SC CGRP antagonists’ ability to sustain (let alone grow) their current physician-reported share. Indeed, physicians anticipate a significant contraction of Aimovig and plateauing of Ajovy share. Emgality appears to escape this class effect with a small projected share increase over the same time period.
  2. While Nurtec ODT was most likely to be the backup agent among patients recently prescribed Qulipta, one in five would have likely been prescribed a SC CGRP antagonist. Instead, Qulipta was selected due to patients’ needle phobia/aversion and the gepant’s oral dosing profile. Strong Qulipta expansion could result in twenty percent or more of new prescription opportunities being lost for these brands, with Aimovig especially likely to feel the strain.
  3. Qulipta will be strongly competitive on overall risk-benefit profile in comparison to the SC brands. Agreement is high that Qulipta will provide at least equivalent efficacy to that of the SC CGRP antagonists, consistent with efficacy being the most influential driver of initiations. In addition, physicians are more than twice as likely to believe that Qulipta outperforms Emgality on tolerability than vice versa.
  4. If AbbVie is successful in the attempt to expand the Qulipta label to include the preventive treatment of chronic migraine, the erosion of the SC CGRP antagonist prescribing patterns will accelerate. Two-thirds of physicians agree that data supporting the efficacy of Qulipta for the prevention of chronic migraine would greatly increase their use of the brand.

At this time, the gepants are only approved for the preventive treatment of episodic migraine, while the SC CGRP antagonists have broad labels covering both episodic and chronic migraine. Biohaven does not have a late-stage Nurtec ODT clinical program for chronic migraine, which would leave Qulipta as the sole gepant disrupting the status quo in this segment of the market – at least until Biohaven’s oral zavegepant is potentially approved towards the end of 2023.

Spherix will continue to assess Qulipta perceptions and related prescribing patterns via their ongoing Launch Dynamix™, RealTime Dynamix™, and RealWorld Dynamix services.


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Launch Dynamix™ is an independent service providing a monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into patient types initiated, brand perceptions, promotional activity, and drivers and barriers to uptake.

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RealWorld Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year over year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal & demographic data to highlight differences between stated and actual treatment patterns.

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About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.

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