The NHS is to get its first low-cost drug for acute migraine in adults, heralding a “step-change in treatment”, it was announced today.
Newly published draft guidance, from the National Institute for Health and Care Excellence, recommends rimegepant (also called Vydura) for individuals who have tried at least two triptans but they did not work well enough or were not well tolerated.
The clinical trial evidence shows the treatment is more likely to reduce pain at two hours than a placebo. Taken as a wafer that dissolves under the tongue, it stops the release of calcitonin, a gene-related peptide thought to be responsible for the severe pain associated with migraine attacks, NICE says.
Helen Knight, director of medicines evaluation at NICE, said: “This is the first and only NICE-recommended medicine that can help alleviate the misery of acute migraines, and may be considered a step-change in treatment.
“Migraine is a condition described in comments to NICE from carers and people with migraine as an invisible disability that affects all aspects of life including work, education, finances, mental health, social activities, and family.
“Today’s final draft guidance addresses the high unmet need for treatment options for acute migraine, once again demonstrating our ability to ensure clinically and cost-effective medicines are available to those who need them as quickly as possible.”
Rimegepant could eventually be used in primary care but should initially be started in secondary care.
NICE expects to publish its final recommendations in October.
The drug costs £12.90 per 75 mg tablet and the recommended dose is 75 mg as needed, not more than once daily.
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