To the Editor Loder and Burch1 discuss the merits and cautions of calcitonin gene–related peptide (CGRP) and CGRP receptor monoclonal antibody preventive therapy for migraines. However, their conclusion that there are “3 less expensive” treatments before using CGRP/CGRP receptor monoclonal antibody (mAb) treatments has no scientific foundation.
They quote a price of $8500 per year or more for mAbs. The US list price of erenumab is $575 for once monthly 70-mg or 140-mg single-use prefilled autoinjectors, or $6900 annually (data available on https://www.amgen.com/ and https://www.novartis.com/). The average annual health care cost per patient with migraines is $11 010.2 The estimated indirect cost of migraines was $36 billion in 2016.2
Charles JA. Consideration of Costs and Open-label Studies of Erenumab. JAMA Neurol. 2019;76(2):236. doi:10.1001/jamaneurol.2018.4150
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