NICE approves fremanezumab (Ajovy) for episodic migraine

We welcome the decision but are concerned about access to it

16th December 2021

We welcome today’s announcement by the National Institute for Health and Care Excellence (NICE) that fremanezumab (Ajovy) has been approved for use within the NHS in England and Wales for the treatment of episodic migraine. This follows its decision in March 2020 to approve its use to treat chronic migraine, and the Scottish Medicine Consortium’s (SMC) approval of it for the treatment of chronic and episodic migraine in January 2020.

Ajovy is one of a number of new generation of calcitonin gene-related peptide (CGRP) antibody drugs, which are the first medication specifically designed to prevent migraine. This approval improves treatment options for people affected by migraine.

NICE has said that the drug should be available for patients who experience migraine on four or more days a month and who have already failed to respond to at least three other migraine preventive drugs. Migraine preventives are medicines usually taken daily to prevent or reduce the number and severity of migraine attacks.

Importance of access to this medication

Clinical Commissioning Groups in England now have three months to comply with this recommendation. The NHS in Wales has two months to comply.

However, a report that we recently published highlighted how many migraine patients that were eligible for these CGRP antibody medication were struggling to access them. Our Dismissed for too long report revealed that only 15 Trusts in England (out of 128 contacted), and 10 Health Boards in Northern Ireland, Scotland and Wales (out of 26), replied to our Freedom of Information requests and stated that eligible patients could access CGRP treatment.

“It is wonderful news that more people who live with this painful, debilitating and exhausting brain disease are now eligible for this important treatment. However, it is crucial that they can actually access it. Our research and speaking directly with people affected by migraine has shown that too many are unable to access these treatments. This is not only costing those who have to live with migraine but the lack of adequate migraine treatment is bad for the NHS too. Migraine causes 16,500 emergency admissions every year, at a cost of £11.5m. As we move into 2022, we hope that local healthcare providers will do more to ensure that there is greater access to this potentially life changing treatment.”

Rob Music, Chief Executive of The Migraine Trust