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Aimovig – also known as erenumab – is the first treatment to target the process that leads to migraine symptoms. The drug contains cloned immune cells that block a mechanism that causes blood vessels in the brain to swell, leading to an attack. Clinicians claimed it was ‘one of the most important advances in migraine therapy in decades’.
Yet, earlier this month, patients were dealt a huge blow when the National Institute for Health and Care Excellence (NICE) – the NHS’s spending watchdog for England and Wales – refused to fund it, even though health chiefs in Scotland have already given it the green light.
NICE said there was not enough proof the drug was clinically more effective than existing treatments, such as regular injections of muscle-relaxing Botox.The decision means NHS doctors have effectively been barred from using it until NICE reconsiders whether it is worth it or not.In the meantime, hundreds of desperate patients have been paying around £5,000 a year to private clinics for monthly injections of Aimovig in the stomach, thigh or arm.
Those numbers are expected to rise further in the wake of NICE’s rejection.One such patient is dad-of-one and former tax accountant Phil Walsh, 69, from North Tyneside. He was forced to take early retirement at 54 due to severe migraines that struck almost daily.But since starting on Aimovig last November, Phil says his life has been transformed.
These work by blocking the effects of a protein called calcitonin gene-related peptide, which is involved in transmitting pain signals to the brain and is found in increased levels during migraine attacks. At least two other similar drugs have been licensed and are due for NICE assessment in the next few months.
But NICE barred Aimovig’s use even though the drug is licensed to be used only after at least three other existing medications have failed. It concluded it was ‘very uncertain whether erenumab is more clinically effective’ than Botox. The London-based National Migraine Centre says it has prescribed the drug – which can be injected by patients in the comfort of their own home – to nearly 200 migraine sufferers over the past year or so.
It says more than two-thirds reported an improvement in quality of life and 75 per cent said they would recommend it to other migraine sufferers.Professor Peter Goadsby, from King’s College London, is one of Britain’s leading migraine experts and led the research into CGRP’s role in triggering the agonising attacks. He said the NICE rejection came as a big surprise.
‘Most of us in the field thought it would get the go-ahead for chronic migraine,’ he said. ‘It’s frustrating. ‘Hospitals are strapped for resources and here we have a treatment that people can administer in their home. ’Prof Goadsby called on NICE to reconsider its decision. Experts point out that whereas Botox has to be injected up to 30 times in a course of treatment by a trained health professional in a hospital clinic, Aimovig is a do-it-yourself jab that can be done at home.
Novartis, which makes the drug, has offered to only charge the NHS for patients for whom it works.After almost two decades of near constant agony, Phil is now hoping to enjoy life holidaying with his 67-year-old wife, Elaine.He describes how the condition left him bed-bound, unable to see properly and talking gibberish.
I could be in bed being sick for a week,’ he said. ‘If I moved my head a fraction of an inch I would start throwing up and it could be like that for up to a week. On two occasions, I collapsed at work and colleagues thought I’d had a stroke.‘It would start off with blurred vision, so bad I couldn’t see anything. Then my fingers would go numb, followed by my mouth and tongue. That would be followed by a period, often lasting several hours, where I could not speak coherently. ‘I knew what I wanted to say but it came out as a load of rubbish. ’After repeatedly having to cancel meetings with clients, Phil took the difficult decision to retire early.
Twice he has been admitted as an inpatient at King’s College Hospital after being crippled by blinding migraine attacks. Despite trying an array of medicines – including triptans and epilepsy drugs – nothing worked. Botox provided some short-term relief but it too eventually stopped working altogether.
Source: Dailymail