Medicated wafer to be approved for the treatment of frequent migraines on the NHS

Rimegepant will be available on the NHS for patients who have tried at least 3 other preventative therapies, and have at least 4 and fewer than 15 migraine attacks per month.

man holding forehead in pain — It is estimated that around 145,000 people could benefit from the treatment

Patients with regular migraines, who have tried at least three other preventative treatments, will be eligible for treatment with a new oral therapy, under a draft National Institute for Health and Care Excellence (NICE) appraisal, published on 31 May 2023.

Rimegepant (Vydura; Pfizer), administered as a dissolvable wafer placed underneath the tongue, will be available on the NHS for patients who have at least 4 and fewer than 15 migraine attacks per month.

The treatment targets the protein calcitonin gene-related peptide (CGRP), which is thought to be associated with the vasodilation and release of inflammatory mediators associated with migraine. There are also injections available that target CGRP, but this is the first time that an oral option is on offer.

NICE estimates that around 145,000 people could benefit from the treatment, but campaigners have raised concerns some people could miss out.

Helen Knight, director of medicines evaluation at NICE, said migraines were often an “invisible disability” and “blighted” millions of lives.

She said: “Rimegepant is the first oral treatment for migraine to be recommended by NICE — and for many thousands of people, it is likely to be a welcome and more convenient addition to existing options for a condition that is often overlooked and undertreated.”

Figures reveal that one out of every seven people in Britain suffers from some level of migraine and that women are more prone to the condition than men.

Peter Goadsby, a professor of neurology at King’s College London, said the “decision offers an important advance in treatment options for those who do not respond or cannot tolerate current treatments”.

The charity the Migraine Trust welcomed the plan but was “disappointed” the drug was not offered more widely to migraine sufferers.

Rob Music, chief executive of the Migraine Trust, said: “This would make a huge difference to people affected by medication-overuse headache, [and] those who are unable to take other acute treatments and who have not responded well to the currently available acute treatments.”