Top U.S. insurer to cover Amgen, Eli Lilly migraine drugs, exclude Teva

“We are pleased that all three companies have chosen Emgality to be one of the preferred medications, making it accessible to even more patients suffering from a migraine,” Eli Lilly said in an emailed statement.

NEW YORK: A top U.S. pharmacy benefits manager (PBM) owned by United Health Group Inc has included new migraine drugs from Amgen Inc and Eli Lilly and Co as preferred treatments on its lists of covered drugs, according to an OptumRx client note viewed by Reuters.

Teva Pharmaceutical Industries Ltd’s rival migraine headache preventer is excluded on one list and patients can pay more for it in some cases on a second list, the note said.

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As with rival PBMs Express Scripts and CVS Health Corp, OptumRx’s lists of covered drugs, or formularies, cover tens of millions of consumers who receive their healthcare from employers and health insurers.

About 39 million Americans suffer from migraine headaches, according to the Migraine Research Foundation, and global migraine drug sales could reach $8.7 billion by 2026, according to analytics firm GlobalData.

OptumRx’s decision secures easier access to customers for Lilly’s Emgality at all three of the biggest PBMs - including CVS and Express Scripts - and gives Amgen’s Aimovig a leg up after CVS decided not to include it on its preferred drug list.

Teva’s Ajovy only has preferred status at CVS, while Amgen also has it at Express Scripts, part of Cigna Corp.

“We are pleased that all three companies have chosen Emgality to be one of the preferred medications, making it accessible to even more patients suffering from a migraine,” Lilly said in an emailed statement.

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Inclusion on a preferred drug's list by the largest PBMs and health insurers is critically important for sales of new medicines. Increasingly, PBMs are choosing a subset of treatments for their coverage list when there are multiple treatments that are considered equivalent.

The three treatments, approved by the U.S. Food and Drug Administration last year, belong to a class of drugs called CGRP inhibitors that have proven effective in helping to prevent migraines.