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Report: Neurologists See Fixed-Dose Sumatriptan/Naproxen as ‘Gold Standard’ of Migraine Treatment

MCO pharmacy directors welcome new migraine drugs (Apr. 3)

In a survey conducted by Decision Resources, a research and advisory firm based in Burlington, Mass., U.S. neurologists agree that sustained freedom from pain beyond 2 hours is one of the attributes that most influences their decisions when prescribing acute treatments for migraine. Clinical data and the opinions of interviewed thought leaders indicate that, among emerging therapies, orally inhaled dihydroergotamine (Levadex, MAP Pharmaceuticals/Allergan) and sumatriptan intranasal powder (OptiNose US, Inc.) have advantages over sales-leading oral rizatriptan (Maxalt and Maxalt MLT, Merck) for this attribute.

The company also finds that a fixed-dose combination of sumatriptan and naproxen (Treximet, GlaxoSmithKline/Pozen) is viewed as the current “gold standard” treatment for migraine. Clinical data and the opinions of interviewed thought leaders indicate that treximet has the strongest clinical profile of the key products marketed for the acute treatment of migraine.

“Despite Treximet’s strong clinical profile, it was not the 2011 sales leader, owing largely to its late-to-market launch and its more restricted reimbursement, given the generic availability of its individual components,” said analyst Anne-Elise Tobin, PhD. “Through 2021, we do not expect any emerging therapy to replace Treximet as our proprietary clinical gold standard — although many agents offer some efficacy, safety and tolerability, and/or delivery advantages.”

The report also finds that, in line with surveyed neurologists, surveyed pharmacy directors at U.S. managed care organizations (MCOs) are receptive to new acute migraine therapies that offer increased sustained freedom from pain compared with currently available therapies. Surveyed pharmacy directors were also receptive to therapies that provide improved pain relief at 30 minutes. Although some emerging therapies hold promise for offering these improvements, no agents are expected to match the clinical improvement over current therapies that surveyed U.S. payers indicated would be necessary for widespread inclusion on MCO formularies.

Source: Decision Resources; April 3, 2013.

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