NICE delivers final ‘no’ to Novartis migraine treatment Aimovig

Novartis has been delivered another ‘no’ for its migraine treatment Aimovig from NICE following draft guidance which rejected the drug earlier this year.

The final appraisal supports the original decision that was made, that Novartis lacked a significant amount of data which meant it could not recommend the treatment for routine use on the NHS. NICE said the trials of Aimovig “excluded people for whom all previous treatments had no therapeutic benefit.” This significant population, largely represents those that would be most in need of the treatment and the “most clinically important subgroup."

With further reference to the data, NICE pointed out that no-where in the long term data was there proof that Aimovig presented a clear sustained benefit, and that it only included people with episodic migraine and did not specify how many previous treatment they had failed before taking the drug.
The agency also presented concerns that for the chronic migraine subgroup , there was no direct comparison with the current treatment in use (Botox), so its superiority is uncertain.

As a result, NICE determined the cost-effectiveness estimates are higher that what is deemed acceptable even with Novartis offering NICE a confidential discount to the £5,000 per year list price.
Novartis has responded that it is very disappointed in the decision, believing that it does have benefits over the current standard of treatment, including its self-administering dosing which means patients do not have to repeatedly attend clinic appointments.

Aimovig is avaliable for use in NHS Scotland and NICE has been met with criticism for establishing a post code lottery of success with those who cannot afford the medicine cut off from the potential benefits of the drug. Chief Executive of the Migraine Trust, Gus Baldwin, has said that it is a “very bad day for chronic migraine patients”

Since being approved by the European Commission in 2018, Novartis has seen rivals emerge from Eli Lilly and Teva. However Aimovig has managed to establish itself as the lead product in the market, with estimated sales of $2.05bn in 2024 by Evaluate Pharma.

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