On 20 January 2023, we sent Pharmac a letter, signed by all four of New Zealand’s headache specialists, raising concerns about its slow handling of the funding application for erenumab (Aimovig), the (in)appropriateness of their review process and how this would affect the application we made in November 2022, for the funding of galcanezumab (Emgality).
On 15 February 2023, we got a reply. That’s a big step up from the speed at which they’re reviewing erenumab. It was signed off by the Chief Medical Officer, which made us feel like someone near the top was listening. And it contained some very encouraging news.
Pharmac acknowledged the delays the erenumab application is experiencing and stated their intent (not quite a commitment, but definitely an intent) to have the Neurological Advisory Committee meet this year. This is the committee that needs to review erenumab before any further progress can be made. We await with bated breath for this to be scheduled, but we won’t hold our breaths, because we know that even once the meetings happen, it takes a couple of months for the minutes to be released, and then we have to wait for Pharmac to assess the advice from the committees and prioritise the application.
We were more excited about their response to our request that galcanezumab (Emgality) would be assessed for treatment of people with episodic migraine (who have headache days on 14 days or less a month) as well as those with chronic migraine (headache days on 15 days or more a month).
Pharmac is doing this, and have even created a separate application to cover this, based on the information we provided about episodic migraine treatment in our original application (check it out here). We have the opportunity to provide Pharmac with additional information regarding Emgality and episodic migraine, and we’ve already added in some supplementary evidence we think is important they consider.
We don’t yet know when this application will be reviewed by a committee. The usual process is for applications to go to the general Pharmacology and Therapeutics Advisory Committee (PTAC), which meets quarterly, which may then refer the application to a specialist committee (like the neurological one). We’re settling in for a long ride.
But we're very pleased Pharmac expressed a desire to meet with us (several times, which was heart-warming) to talk about the consumer voice and lived experience of people with migraine and incorporating this into the funding application process. They were also open to having additional input from headache specialists about migraine treatment. We will be following up on both of those options. If you have experience using Emgality or Aimovig and would like to share this with Pharmac (it can be anonymously or not), please email us: firstname.lastname@example.org.
And keep up the advocacy efforts. The more we open up about the impact of migraine and how urgently we need better treatment options, the better.