Migraine Foundation Aotearoa New Zealand has submitted a consumer application to Pharmac to fund Emgality (galcanezumab) for the treatment of chronic migraine.
Emgality is one of several monoclonal antibody medications that act to block a protein, calcitonin gene-related peptide (CGRP), which is involved in triggering migraine attacks.
CGRP monoclonal antibodies are the first medications developed specifically to prevent migraine. Prior to their development, the only preventive medications used for migraine were medications developed for other conditions, such as depression, epilepsy and high blood pressure, that were found to be useful to prevent migraine.
CGRP monoclonal antibody medications are a significant development in migraine treatment. They’ve been found to be safe and effective, with fewer side effects than many other preventive migraine medications.
Emgality is funded in many other OECD countries, including Australia, the United Kingdom, the United States and Canada. In New Zealand, people must pay around $325 per injection – 2 injections are needed at the beginning of treatment and then one injection every 4 weeks.
“Overseas, people with migraine have had access to these medications for years,” Suzanne Vale, Migraine Foundation Aotearoa New Zealand co-founder says.
“But people with migraine in New Zealand haven’t. And while Emgality is available in New Zealand, the price means it’s out of reach of many people who would benefit from it,” Suzanne says.
An estimated 642,000 people live with migraine in New Zealand, and it is the fourth highest cause of disability. It’s estimated 45,000 people in Aotearoa New Zealand have chronic migraine, where people experience headache on 15 days or more per month, of which at least eight have symptoms of migraine. Migraine symptoms, which usually worsen with movement, include nausea, vomiting, and sensitivities to light, sound, or smell, on top of the moderate to severe head pain that can be pulsating or throbbing which migraine is known for. Migraine attacks that occur less frequently are known as episodic.
In New Zealand, chronic migraine prevalence is similar to epilepsy, but more common than many other significant neurological conditions including stroke, Parkinson’s disease and multiple sclerosis.
Emgality has been shown to be effective in preventing migraine attacks in people with both episodic and chronic migraine, significantly reducing the number of monthly migraine days and disability from migraine.
“We know from overseas research that migraine costs governments, employers, whānau and individuals. Chronic migraine is associated with lost productivity from work, lower levels of education and a reduced ability to engage in employment,” Suzanne says.
“We had 540 people respond to our recent Migraine in Aotearoa New Zealand survey. Of those with chronic migraine, 23 percent reported being unable to work, which is double what those with episodic migraine reported, and only four percent reported no work-related difficulties, compared to just 21 percent of those with episodic migraine.”
“People in New Zealand deserve funded access to modern migraine medications to help us fully partake in life and work. And to reduce the burden of migraine on society overall.”
The funding application to Pharmac should be considered by the Pharmaceutical Therapeutic Advisory Committee (PTAC) in 2023, at the earliest during their meeting on 16-17 February. Decisions from PTAC meetings are usually made public three months after the meeting date.
Migraine Foundation Aotearoa New Zealand is calling on the migraine community to support its application to Pharmac. The Foundation has developed an advocacy toolkit that includes practical ways people can take action and raise awareness of the importance of funding Emgality.