Ubrogepant (Ubrelvy)

Key Messages

• Canada’s Drug Agency (CDA-AMC) recommends that Ubrelvy be reimbursed by public drug plans for the acute treatment of migraine, with or without aura, in adults if certain conditions are met.
• The Canadian Drug Expert Committee (CDEC) determined that Ubrelvy demonstrates acceptable clinical value compared with appropriate comparators (triptans) in adult patients with migraine. This determination was enough for CDEC to recommend that Ubrelvy be reimbursed. Evidence from 2 clinical trials showed that patients who had a migraine attack and took Ubrelvy were more likely to be pain free or have less severe pain, and they were less likely to have symptoms associated with migraine, when compared with patients taking a placebo pill. Evidence from an indirect treatment comparison was associated with limitations and did not consistently demonstrate meaningful differences between Ubrelvy and publicly funded oral triptans that are commonly used to treat migraine attacks. While acknowledging the uncertainty of the indirect treatment comparison, CDEC found it reasonable to consider Ubrelvy and publicly funded oral triptans comparable.
• Ubrelvy should only be covered for adults with migraine, with or without aura.
• Ubrelvy should only be reimbursed if initiated in adults with a history of migraine attacks associated with moderate to severe headache pain. Alternatively, public drug plans may choose to align the reimbursement criteria for Ubrelvy with existing formulary criteria for triptans, where such criteria exist. In either case, the cost of Ubrelvy should not exceed the least costly oral triptan used for the same indication.
• Important budget impact considerations must be addressed for health systems to be able to adopt Ubrelvy.