An Analysis of Differences in Patient Access to CGRP Migraine Treatments in the Nordic Region
Author(s)
Eoin M. Ryan, MSc Health Economics, Policy, and Management1, Milena Izmirlieva, MSc2.
1LSE, London, United Kingdom, 2Senior Director, Research & Analysis, GlobalData, London, United Kingdom.
1LSE, London, United Kingdom, 2Senior Director, Research & Analysis, GlobalData, London, United Kingdom.
OBJECTIVES: To evaluate reimbursement access and price trends for new calcitonin gene-related peptide (CGRP) migraine treatments in Denmark, Finland, Iceland, Norway and Sweden using GlobalData POLI.
METHODS: Differences in pricing and reimbursement (P&R) and HTA outcomes in the Nordics for CGRP inhibitor anti-migraine medicines were assessed using data GlobalData’s proprietary POLI database. Specifically, descriptive statistics were drawn from POLI for time to HTA outcome, time to first price, time to reimbursement, and price changes over the past five years for the monoclonal antibody (mAbs) CGRP inhibitors Aimovig (erenumab), Ajovy (fremanezumab), Emgality (galcanezumab) and Vyepti (eptinezumab), as well as the oral small molecule CGRP receptor antagonists Aquipta (atogepant) and Vydura (rimegepant). The analysis on P&R trends was cross-referenced with information retrieved from national sources on reimbursement eligibility, treatment guidelines, prescription data, and market share to assess overall patient access.
RESULTS: The analysis indicates that Finland and Sweden are the only Nordic countries that granted general reimbursement status to all six CGRP inhibitors. Iceland reimburses Aimovig, Ajovy, Vyepti, Aquipta, and Vydura but does not fund Emgality in the public healthcare system. Norway and Denmark have the strictest reimbursement rules for CGRP migraine treatments. Norway partially reimburses Vyepti and Vydura. Denmark only reimburses Vydura via a risk sharing agreement, whereby the market authorization holder must cover public reimbursement costs for extra patients. There is therefore significant variation in patient access to migraine treatments between Nordic countries.
CONCLUSIONS: In the Nordic region, price sensitivity is not the main factor driving reimbursement decisions and patient preferences for one CGRP inhibitor over another. The data points to the influence of patient-friendly administration routes, plus HTA focused health benefit assessments, rather than average therapy costs, as the main factors determining the large differences in patient access between Nordic countries.
METHODS: Differences in pricing and reimbursement (P&R) and HTA outcomes in the Nordics for CGRP inhibitor anti-migraine medicines were assessed using data GlobalData’s proprietary POLI database. Specifically, descriptive statistics were drawn from POLI for time to HTA outcome, time to first price, time to reimbursement, and price changes over the past five years for the monoclonal antibody (mAbs) CGRP inhibitors Aimovig (erenumab), Ajovy (fremanezumab), Emgality (galcanezumab) and Vyepti (eptinezumab), as well as the oral small molecule CGRP receptor antagonists Aquipta (atogepant) and Vydura (rimegepant). The analysis on P&R trends was cross-referenced with information retrieved from national sources on reimbursement eligibility, treatment guidelines, prescription data, and market share to assess overall patient access.
RESULTS: The analysis indicates that Finland and Sweden are the only Nordic countries that granted general reimbursement status to all six CGRP inhibitors. Iceland reimburses Aimovig, Ajovy, Vyepti, Aquipta, and Vydura but does not fund Emgality in the public healthcare system. Norway and Denmark have the strictest reimbursement rules for CGRP migraine treatments. Norway partially reimburses Vyepti and Vydura. Denmark only reimburses Vydura via a risk sharing agreement, whereby the market authorization holder must cover public reimbursement costs for extra patients. There is therefore significant variation in patient access to migraine treatments between Nordic countries.
CONCLUSIONS: In the Nordic region, price sensitivity is not the main factor driving reimbursement decisions and patient preferences for one CGRP inhibitor over another. The data points to the influence of patient-friendly administration routes, plus HTA focused health benefit assessments, rather than average therapy costs, as the main factors determining the large differences in patient access between Nordic countries.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR20
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
Neurological Disorders