The US Food and Drug Administration‘s (FDA) recent approval of a new migraine treatment marketed by Amgen and Novartis has met with an enthusiastic response since it was greenlighted in May; however, pharma market watchers are waiting to see what happens when patients and insurers have to pay the high price.

With a list price of $6,900 – still below the $8,000 to $10,000 expected by analysts – the new treatment, Aimovig, blocks a protein fragment that instigates and perpetuates migraines. It is the first of several new treatments expected to be launched in the near term. Eli Lilly, Teva and Alder also have medicines targeting the calcitonin gene-related peptide pathway in late-stage trials or awaiting FDA approval.

Regarding the potential competition, Rob Lenz, Amgen’s vice president of development, said Aimovig has a tolerability profile "similar to a sugar pill, along with efficacy that can be seen within days.” The once-monthly self-injection, he added, allows patients "built-in compliance" as they don't have to remember to take a pill every day. Lilly's injection is also monthly, while Teva's has been tested with monthly and quarterly schedules and Alder’s is a quarterly injection.

The emergence of the new class of migraine treatments is especially interesting to the markets as up to now there have been no drugs specifically developed to treat the severe headaches. “There is clearly a lot of demand for the product, and our expert said the companies being overwhelmed in trying to keep up with the initial interest,” Credit Suisse analyst Vamil Divan said in a note to clients after talking with a migraine specialist from Yale University.

Divan said a large number of patients are contacting their neurologists and primary care physicians to inquire about the new treatment option. Some payers, such as PBM Express Scripts in the US, have established a prior authorization program.

Weighing in on the prospects for drugmakers in an increasingly crowded new field, the analyst said the drugs administered quarterly, in particular Alder’s eptinezumab, may have a convenience advantage. The latter is injected by a healthcare professional rather than requiring self-injection.

One in seven people worldwide are said to experience migraines. While the older non-specific drugs sometimes had severe side effects, participants in clinical trials with the new drugs reportedly suffered no more side effects than those taking a placebo.