New hope for the significant number of people living with the pain and disability caused by migraine, with uncertainty regarding the arrival of the next crisis. This neurological disease affects 12% of the Spanish population, four million people, 80% of whom are women, especially between 20 and 40 years old. According to the WHO, there are more than 1 billion people affected worldwide and it is one of the ten most disabling pathologies, since 90% of patients cannot work or do daily activities during a crisis.
Despite the high incidence, almost 54% of those affected in Spain say that they have not found a useful solution to cope with the effects of this chronic pathology. In this context, the first medicine authorized for both the acute treatment of migraine, with or without aura, and for the preventive treatment of episodic migraine in adults who suffer at least four attacks per month, has been marketed in Spain.
Vydura, the trade name of the active ingredient rimegepant, represents an advance for the therapeutic approach to migraine, both palliative and preventive, and was authorized by the European Commission in April 2022. In Spain, the Interministerial Commission on Drug Prices approved the financing of the new therapy setting a price of 464.34 euros for each container of 16 tablets. Vydura requires a prescription, and public funding does not extend to all patients.
“The indication that is funded is prevention, with some limitations: those patients who have between 8 and 14 migraine attacks per month, who have undergone at least three previous treatments without an adequate response for three months and have a prescription for a specialist, they will be able to access reimbursement from the National Health System,” explained yesterday José Chaves, medical director of Pfizer Spain, the manufacturer. Patients who do not meet these requirements can access the medication at pharmacies, but at its market price (29 euros per tablet) and always with a prescription. The recommended dose for the acute treatment of migraine is one Vydura tablet, as needed, once a day. As for prevention, a dose every two days is recommended.
Rimegepant acts on the calcitonin gene-related peptide pathway. Around 20% of patients do not feel pain two hours after administration in a crisis situation, according to the pharmaceutical company's studies. Regarding prophylaxis (one pill every two days for 16 months), the trials indicate an overall average reduction of 6.2 migraine days per month in each treated patient. “It is an oral treatment that has a rapid onset of action, in two hours or less it reduces pain and lasts up to 48 hours,” said Chaves, who highlighted the scarcity of side effects.
Jesús Porta-Etessam, president of the Spanish Society of Neurology, emphasizes the misunderstanding and stigma surrounding migraine: “Due to the fact that it is a disease that occurs through crises, when the patient does not have pain, they tend to have a long life. supernormal, the saying, makes a special effort to do everything that it cannot do during the migraine.
