Lack of drive could slow down Reyvow sales

Just when it seemed that the world of migraine could not get more crowded, Lilly’s lasmiditan, now branded Reyvow, has been approved. In the past 16 months three new CGRP migraine treatments have entered the market, explaining why Lilly is keen to point to Reyvow’s different mechanism, targeting the 5-HT1F receptor. However, Reyvow’s side effects might hold back uptake. Users are banned from driving for eight hours after taking the acute migraine treatment, a potential deal-breaker for younger working patients. The product is also associated with dizziness, and DEA scheduling will complicate prescribing. However, all might not be lost. Reyvow does provide another option for the estimated four million Americans who cannot take triptans, or patients who do not respond to CGRPs. As an acute treatment Reyvow might also be useful in combination with preventative CGRPs, allaying physician concerns around over-blocking the CGRP receptor when acute and preventative CGRPs are used together. While Reyvow is not expected to be a blockbuster, it could still achieve respectable niche sales.

Selected migraine products
Product Company

Pharma class

2024e sales ($m) Phase
Aimovig Amgen/Novartis Anti-CGRP MAb 1,968 Marketed
Emgality Lilly Anti-CGRP MAb 1,159 Marketed
Rimegepant Biohaven Oral CGRP antagonist 875 Filed
Ajovy Teva Pharmaceutical Anti-CGRP MAb 840 Marketed
Eptinezumab Alder Anti-CGRP MAb 807 Filed
Reyvow (lasmiditan) Lilly 5-HT1F agonist 365 Approved
Ubrogepant Allergan Oral CGRP antagonist 302 Filed
Atogepant Allergan Oral CGRP antagonist 185 Phase III
Source: EvaluatePharma.

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