OBJECTIVES

: Galcanezumab-gnlm is a newly approved calcitonin gene-related (CGRP) inhibitor indicated for the prevention of migraine in adults.

This study aimed to estimate the budget impact of adding galcanezumab-gnlm as a preventive treatment for patients with migraine in a US Commercial population.

METHODS

: A budget impact model with a 1 to 5-year time horizon was developed to evaluate the financial impact of including galcanezumab-gnlm as a preventive treatment for prevention-eligible patients with migraine. The population was based on a hypothetical one million commercially insured members. The current scenario included CGRP inhibitors, antiepileptics, beta-blockers, antidepressants, and onabotulinumtoxinA (chronic migraine only). The new scenario included galcanezumab-gnlm as a new treatment, without change to market size or total predicted CGRPs uptake. Calculations relied on estimated epidemiology, market share, drug and administration costs. Deterministic sensitivity analyses were conducted, including the impact of healthcare resource use, to identify key drivers and assess uncertainties.

RESULTS

: Over a 3-year period, the analysis estimated 53,090 patients with migraine would be eligible for preventive treatment, with 0.8%, 2.40%, and 4.8% of them prescribed galcanezumab-gnlm in the first, second, and third year, respectively. Overall, the addition of galcanezumab-gnlm resulted in no change to a plan budget. The cost per member per month was estimated to remain at $1.22 for both the scenario with or without galcanezumab-gnlm. The lack of budgetary change was attributable to treatment cost parity across CGRPs over 3 years and no change in the CGRP market size with the addition of galcanezumab-gnlm. Sensitivity analyses suggested uptake and drug costs of galcanezumab-gnlm and other CGRPs were key drivers of results.

CONCLUSIONS

: When compared to a current scenario that includes CGRP use and assuming no increased market size, the introduction of galcanezumab-gnlm as a preventive treatment of migraine will not lead to an increase of a US commercial payer budget.