Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that the use of Allergan’s Botox for the prophylactic treatment of chronic migraine will increase modestly in the major pharmaceutical markets (United States, France, Germany, Italy, Spain, the United Kingdom and Japan) through 2022, despite lingering clinical and market access hurdles.

The drug’s expanding role, especially in the United States, coupled with its premium price, will propel its major-market sales for migraine to nearly $850 million in 2022. Greater use of Botox will help drive 4 per cent annual growth of the total migraine market—which includes both episodic and chronic migraine—which Decision Resources forecasts will expand from nearly $3.6 billion in 2012 to $5.4 billion in 2022.

The Pharmacor advisory service entitled Migraine finds that the expected launch of two premium-priced nontriptan therapies for the acute treatment of migraine, Allergan’s Levadex and CoLucid Pharmaceuticals’ 5-HT1F receptor agonist lasmiditan, will also fuel the migraine market growth through 2022. As therapeutic alternatives for triptan nonresponders, patients unable to tolerate triptans, or, in the case of lasmiditan, patients in whom triptans are contraindicated, these agents are expected to earn combined sales accounting for 25 per cent of the total migraine market in 2022.

The findings also reveal that the projected launch of APR Applied Pharma Research/tesa Labtec’s Zolmitriptan RapidFilm (zolmitriptan oral dispersible film) in additional markets and the launch of four novel triptan reformulations in the United States through 2017 will partially offset generic erosion of this drug class. Emerging reformulations include NuPathe’s sumatriptan transdermal patch Zecuity, IntelGenx/RedHill Biopharma’s rizatriptan oral film (INT-0008), Avanir Pharmaceuticals/OptiNose’s sumatriptan intranasal powder (AVP-825) and Suda’s sumatriptan oral spray (SUD-001). Although these niche products are forecast to garner modest patient shares, their combined sales will contribute nearly 15 percent market share at end of our forecast period.

“Although the triptan drug class is crowded and increasingly generic, opportunity exists for alternative acute antimigraine therapies that offer unique mechanisms of action or improved efficacy and/or safety profiles,” said Decision Resources senior director Bethany A Kiernan. “At the same time, in the forecasted absence of any new prophylactic therapies, owing in large part to a small development pipeline, improved prophylactic therapies remain one of the greatest unmet needs in migraine treatment.”