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F.D.A. Approves First Drug Designed to Prevent Migraines

The first medicine designed to prevent migraines was approved by the Food and Drug Administration on Thursday, ushering in what many experts believe will be a new era in treatment for people who suffer the most severe form of these headaches. The drug, Aimovig, made by Amgen and Novartis, is a monthly injection with a device similar to an insulin pen. The list price will be $6,900 a year, and Amgen said the drug will be available to patients within a week.

Aimovig blocks a protein fragment, CGRP, that instigates and perpetuates migraines. Three other companies — Lilly, Teva and Alder — have similar medicines in the final stages of study or awaiting F.D.A. approval. "The drugs will have a huge impact," said Dr. Amaal Starling, a neurologist and migraine specialist at the Mayo Clinic in Phoenix. "This is really an amazing time for my patient population and for general neurologists treating patients with migraine."

Millions of people experience severe migraines so often that they are disabled and in despair. These drugs do not prevent all migraine attacks, but can make them less severe and can reduce their frequency by 50 percent or more. As a recent editorial in the journal JAMA [DOI: 10.1001/jama.2018.4852] [DX] put it, they are "progress, but not a panacea."

Sticker shock? The price is 30% less than Wall Street expected. Meanwhile, people are self-administering psychedelics such as LSD or psilocybin to treat migraines and cluster headaches.

See also: FDA just approved the first drug to prevent migraines. Here's the story of its discovery—and its limitations

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