NICE shoots down Novartis' migraine drug Aimovig outside of Scotland

NICE has announced its decision to reject Novartis’ drug Aimovig (erenumab) for use on the NHS in England and Wales for the prevention of chronic and episodic migraine in adult patients who experience at least four episodes of migraine a month.

NICE said that Novartis had proposed that the drug be offered to patients who have not seen an adequate response from at least three other treatments for episodic or chronic migraine, but an independent committee voiced concerns over the aptitude of the clinical data provided to support the application.

It noted that the data appeared to exclude patients who had seen no therapeutic benefit from the previous therapies they had tried – a group which the committee considered to be the most in need of treatment and the most clinically important subgroup.

Despite Novartis’ submission of long-term effectiveness data, the committee was concerned that these only included those with episodic migraine without specifying how many prior treatments had failed a patient, so couldn’t assuage concerns over the drug’s long-term efficacy and was therefore judged to be of limited relevance to the target population of the company’s application.  

No direct evidence was provided comparing Aimovig to botulinum toxin type A, the standard of care in the NHS for the treatment of chronic migraine. No updated cost-effectiveness data was provided for episodic migraine at all. Ultimately, cost-effectiveness estimates came in higher than that which NICE could support.

“We’re very disappointed that the NICE has not recommended Aimovig for use on the NHS,” commented Haseeb Ahmad, Managing Director UK, Ireland and Nordics, Novartis Pharmaceuticals & Country President UK. “Clearly this is not the result we’ve been working towards; with chronic migraine patients in England who could benefit from Aimovig being denied routine access to this important treatment option, whilst it is NHS funded in Scotland.

Matt Fellows