Express Scripts Launching Value-Based Migraine Program

Express Scripts has announced the launch of its new SafeGuardRx Migraine Care Value program, which will begin April 1, 2019. According to the pharmacy benefit manager, the program is aimed at helping patients achieve better outcomes and experience fewer migraines with a value-based design to assist plan sponsors in covering new, expensive treatments.

The program will focus on preventive therapies, which are playing a greater role in migraine treatment with the availability of a new class of drugs: calcitonin gene-related peptide (CGRP) inhibitors.

“Right now, most patients take medications to make migraine go away. Our goal is to help frequent migraine sufferers prevent their migraine from coming on at all,” explained Harold Carter, PharmD, senior director, product, Express Scripts, in a statement. “Through the clinical care provided through our new Migraine Care Value program, Express Scripts specialist pharmacists in our Neuroscience Therapeutic Resource Center will identify patients using high amounts of acute migraine treatments, and work with them and their physician to move them to an appropriate treatment.”

CGRP inhibitors hit the market in May with the approval of erenumab (Aimovig) as the first CGRP inhibitor for the prevention of migraine in adults. The approval followed positive results from the LIBERTY trial, which assessed the treatment in patients with episodic migraine who had previously failed on 2 to 4 treatments. Earlier this month, a new analysis reported that the treatment demonstrates efficacy within 1 week of treatment in both chronic and episodic migraine.

Since erenumab’s approval, 2 more CGRP inhibitors have gotten a nod from the FDA: fremanezumab and galcanezumab.

While not all patients with migraine require CGRP inhibitor therapy, the program will prefer erenumab and galcenezumab for those who meet the clinical guidelines for the therapy, and neuroscience specialist pharmacists will show patients how to use the self-injected treatments. According to Express Scripts, they will offer an early discontinuation reimbursement back to plan sponsors if a patient discontinues one of therapies—which both come at an annual cost of $6900—in the first 90 days.

Under the program, patients on preventive therapy will also have access to pharmacists to ensure medication adherence and avoid migraine triggers.

“CGRP inhibitors can be life-changing for people with frequent migraines, which is why it’s critical that these drugs be made affordable to both patients and plan sponsors,” said Carter in the statement. “With our SafeGuardRx solutions, we have pioneered an evidence-based approach that will not help migraine sufferers receive the best medication and specialized care to enable them to lead full and productive lives while reducing costs and wasteful spending for our clients.”