The Scottish Medicines Consortium (SMC) has ruled that adult patients with chronic migraine who have failed on at least three prior prophylactic treatments can be prescribed erenumab on the National Health Service (NHS).1
The SMC decision has taken account of the benefits of a Patient Access Scheme (PAS) that improves the cost-effectiveness of erenumab, and it depends on the continuing availability of the PAS in Scotland or a list price that is equivalent or lower.
In England, clinicians are awaiting a decision from the National Institute for Health and Care Excellence (NICE) about whether erenumab can be prescribed on the NHS. In draft guidance issued in January, NICE concluded that erenumab did not meet cost effectiveness criteria for use on the NHS in England.2 However, following a large volume of comments from stakeholders, further discussion by NICE was delayed until 16 April so that responses could be considered.3
The UK patient organisation, The Migraine Trust, has expressed the hope that NICE will follow the SMC’s lead in chronic migraine and is urging NICE to also make erenumab available to people who have 10 or more migraine or headache days per month – so called ‘high frequency episodic migraine’.