Medsafe has recommended the gepant medication atogepant (Qulipta) be added to the New Zealand Medicines Schedule. Atogepant is used to prevent migraine and is taken daily as an oral tablet.
Atogepant is the first gepant to apply for approval for use in New Zealand, and was recommended to be added to the Medicines Schedule at the Medsafe Medicines Classification Committee meeting held on 25 May 2023, with the minutes published on 4 July.
A recommendation by Medsafe is the first step for medication access in New Zealand. Medsafe is part of the Ministry of Health, and evaluates the safety, efficacy and quality of new medicines. The recommendation goes to the Minister of Health, who then grants consent for the medicine to be marketed in New Zealand. Once this approval is given, the drug company that makes atogepant (AbbVie) will then decide when and how to bring atogepant into the NZ market. Medsafe is responsible for the regulation of medicines, medical devices and other health products in New Zealand, but not for the supply, funding or purchasing of medicines.
Pharmac is the government organisation responsible for deciding which medicines will be publicly funded. Pharmac receives advice from the Pharmacology and Therapeutics Advisory Committee (PTAC) and other Specialist committees to help Pharmac make decisions about which medicines should be funded, and whether medicines are a high or low priority for funding.
Our hope is that AbbVie will submit an application to Pharmac for funding. Consumers can also make an application for funding, as we did when we submitted our application for funding of Emgality (galcanezumab) for episodic and chronic migraine in November 2022.
Gepants are a new oral medication specifically developed for migraine. Four gepants are approved overseas:
Rimegepant (Nurtec ODT)
Gepants are a type of calcitonin gene-related peptide (CGRP) inhibitor, targeting the same peptide as the injectable CGRP medications available in New Zealand, Aimovig and Emgality.
Gepants were originally developed to treat a migraine attack, much like triptans. However, atogepant (Qulipta) was developed for use as a migraine preventive medication, taken daily, and rimegepant (Nurtec) has also been approved for migraine prevention when taken every other day.
Gepants in New Zealand – an update