New migraine headache treatment & costs-

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Joseph Arabasz MD

Nov 30, 2018, 8:28:54 PM11/30/18
Dear Topica,
                          The new compound to treat migraine headaches has been described as efficacious for some

Best wishes always

Thank you for your assistance with this matter


Joseph W Arabasz MD
S/P USAF, Top Secret 1964-69
University of Colorado at Boulder 1972, CU School of Medicine '75, '77, '83
Past Division Chairman, Anesthesiology, Cook County Hospital, Chicago, Illinois
Past Chairman, Respiratory Therapy, Cook County Hospital, Chicago
Diplomate ABA
Sigma Xi, The Professional Science Research Society
PO Box 6939
Denver, CO 80206
USA (2001-2014 site closed/open)

Seems a bit expensive, compared to the efficacious Niaspan OTC extended release pill cost of about $.20

"Since then (to keep things simple as possible), was surprised to see that a single tablet of Niaspan 750mg (or an over the counter sustained release Niacin tablet of the same size) taken immediately with the aura of a migraine would prevent the headache and restore visual defects, possibly by smooth muscle relaxation and the resulting vasodilation to combat the apparent clamping down of blood vessels (with eventual rapid release), which has been described as the etiology of the migraine headache
     Adding a single 100mg immediate release OTC Niacin tablet might be more efficacious with that regimen

The drug's maker, Amgen, said U.S. list price is for the once monthly self-injection treatment will be $575 per month or $6,900 annually

cumulative costs of migraine headaches-

£2.25 billion per year, calculated on the basis of 25 million lost days

£150 million per year, mostly from the costs of prescription drugs and visits. The expenditure on all headache disorders is estimated at £250 million per year

The financial burden of migraine on the is conservatively estimated at £3.42 billion per year. Including all headache disorders the cost rises to £5-7 billion annually
Mean [standard deviation] total annual cost of headache among people with chronic migraine ($8243 [$10,646]) was over three times that of episodic migraine ($2649 [$4634]

 Participants with chronic migraine had significantly greater direct medical costs ($4943 [$6382]) and indirect (lost productivity) costs ($3300 [$6907]) than did participants with episodic migraine (direct, $1705 [$3591]; indirect, $943 [$2084]) (P?<?.001 for each).

Unlike previous findings, direct medical costs constituted the majority of total headache-related costs for both chronic migraine (60.0%, $4943 of $8243) and episodic migraine (64.3%, $1705 of $2649) participants. A large portion of direct medical costs are attributable to pharmaceutical utilization among both chronic migraine (80%, $3925 of 4943) and episodic migraine (70%, $1196 of $1705) participants
Burden – impact and disability
migraine is ranked globally as the seventh most disabling disease among all diseases (responsible for 2.9% of all years of life lost to disability/YLDs) and the leading cause of disability among all neurological disorders.
migraine remains undiagnosed and undertreated in at least 50% of patients, and less than 50% of migraine patients consult a physician

migraines without side effects
When other medications have failed, new injection treatment may help some patients with disabling headaches.
by Shamard Charles, MD / April 17, 2018 / 4:09 PM MDT / Updated May 18, 2018 / 5:30 AM MDT

Millions of Americans suffer from migraine headaches. A new drug, fully human monoclonal antibodies, may help to prevent the excruciating headaches without causing side effects. Milan Ilic Photographer / Shutterstock

The Food and Drug Administration approved a new migraine drug on Thursday.

Aimovig, known generically as erenumab, is the first drug in new headache medicines. It's been shown to prevent migraine headaches before they start.

The drug would be approved for patients who have tried other drugs and found no relief. In studies, it did not entirely prevent migraines, but reduced their frequency.

“Aimovig provides patients with a novel option for reducing the number of days with migraine,” said Dr. Eric Bastings, deputy director of the FDA's neurology products division.

“We need new treatments for this painful and often debilitating condition.”

FDA's approval means the drug may soon be available under prescription. It should also be paid for by health coverage

The drug's maker, Amgen, said U.S. list price is for the once monthly self-injection treatment will be $575 per month or $6,900 annually.

“The price of Aimovig reflects the value it brings to patients and society, including the financial impact on sufferers, caregivers and employers, while also factoring in critical issues such as patient affordability, and fair and timely access,” Amgen said in a statement.

Erenumab is the first new drug that block calcitonin gene-related peptide (CGRP), a molecule that transmits migraine pain signals during an attack. It's a human monoclonal antibody - a targeted immune system protein.

It's formulated as an injection to provide long-lasting protection.


New Drugs Could Ease Migraines
FEB. 23, 201701:45
More than 39 million Americans suffer from migraine attacks, according to the Migraine Research Foundation. Of these, about 4 million have chronic migraine and suffer headaches for 10 to 14 days a month.

While some people are helped by low cost, over-the-counter drugs such as ibuprofen, others need prescription medications, such as sumatriptan and ergotamine, which constrict the blood vessels in the brain and can cause dizziness or nausea. Botox injections are also used to help ease migraines in some people.

But a large percentage of sufferers are not helped by anything

"This is the first-ever mechanism specific migraine drug designed for prevention," said Dr. Peter Goadsby, professor of neurology at Kings College London and the University of California, San Francisco, who is a lead researcher on the drug. "This will change migraine treatment for those who don’t respond to conventional treatments."

Goadsby's team found that the drug reduced the average number of monthly migraine headaches by more than 50 percent for nearly half of study participants. After three months, patients treated with the human antibody were nearly three times more likely to have reduced their migraine days by 50 percent or more than those treated with placebo.

Participants of the study also had a greater average reduction in the number of days with headaches and the number of days they needed to take drugs to stop the migraines.

No patients taking erenumab stopped treatment due to adverse side effects, but the scientists noted that more research will needed to investigate if the benefits continue.

native Denise Desjardins of Malden, Massachusetts, with niece Madeline Salvitella suffered from migraine headaches for over 10 years, particularly around her menstrual cycle,
but found great relief after taking erenumab, a fully human monoclonal antibody drug that is showing great promise in migraine prevention

“I would land in bed for two to three days, four to five times a year,” said Desjardins. “These were in-your-bed, no-matter-what headaches.”

Her migraines became a daily misery after a bilateral mastectomy following a diagnosis of breast cancer. She was put on Imitrex, a popular migraine drug that helps to quiet overactive pain nerves in the brain, but it didn't help.

For about four years, Desjardins has been taking an erenumab injection once a month, without any side effects, as part of the study.

"I don't even think I get migraines anymore," said Desjardins.


Botox injections may relieve migraine pain in children, adolescents
“I think having a treatment that is specifically invented to treat a disease that affects millions of people, makes this a big game changer,” said Dr. Dario Zagar, president of Associated Neurologists of Southern Connecticut.

Because other migraine medications were not developed for headache, their side effects limited how well patients could tolerate them.

“I think someone who gets migraines, will tell you they would do just about anything to reduce how frequently they're getting them — and if you told someone who was getting migraines two or three times a week that they would only get one (a week) or possibly none at all — they would be very happy,” said Zagar

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