B.C. adds migraine medication to coverage, but 'life-changing' drug left off the list
Health Ministry says Aimovig was not considered cost effective
British Columbia's Ministry of Health recently started covering a relatively new migraine prevention medication that some call a "game-changer," but others are left wondering why a similar drug has been left off the list.
Emgality is one of four calcitonin gene-related peptide (CGRP) inhibitors that have been on the market since 2018. The drugs are taken monthly by sub-cutaneous injection, except for one called Vyepti, which is taken by infusion every three months.
Wendy Gerhart, executive director of the non-profit organization Migraine Canada, says the coverage is great news for the thousands of people in B.C. who suffer from the debilitating condition.
"There hasn't really been any new medications to treat migraines since the early 1990s," Gerhart said.
B.C. residents who suffer from migraines can now get coverage for Emgality through B.C. PharmaCare if they qualify for a special authority request. The province's coverage also makes it easier for those with private insurance to get coverage. Otherwise, the drug costs more than $600 per month.
For many, CGRP drugs have been life-changing, says Gerhart.
"They are significant game-changers for a large number of people who live with chronic migraine," she said.
According to Migraine Canada, 4.5 million Canadians suffer from migraines. In B.C., more than 600,000 people suffer from migraines, and 50,000 people live with chronic migraines.
'A huge disappointment'
The province started coverage for Ajovy, another drug under the same classification, last spring. Gerhart says negotiations for Vyepti are underway at the pan-Canadian Pharmaceutical Alliance, a group of provincial and federal governments that collaborate on drug coverage.
But Aimovig, a drug under the same classification, is not on the province's list for coverage. Gerhart says negotiations ended at the pan-Canadian Pharmaceutical Alliance without a letter of intent, meaning there is little chance the provinces will cover the medication.
"That is a huge disappointment for the migraine sufferers who rely on it," she said.
The province says the Ministry of Health reviews all drugs as part of a "rigorous, scientific review process" to "ensure the PharmaCare program is sustainable."
As part of its drug coverage decision, the ministry decided Aimovig showed more benefits than a placebo but the drug wasn't compared with other migraine prevention strategies, and it was not considered cost effective.
The province says the ministry is currently reviewing Qulipta, the first orally-administered CGRP inhibitor.
'Life-changing' experience
Christina Sall, 30, started to use Aimovig in 2019. In 2021, she petitioned the province to cover the drug.
Sall began getting migraines when she was five. By time she was in her early 20s, she was getting up to 20 migraines a month.
Her migraines aren't just a bad headache. They start on the right side of her head until "throbbing, pulsating, stabbing pains" spread through her entire body and she has difficulty speaking.
When she started Aimovig, she went for up to six months without a single migraine.
"It was the most life-changing, best experience of my life," Sall said. "It was the first time I hadn't felt pain — like consistent, chronic pain — in years."
Fingers crossed for coverage
Sall says the effectiveness of Aimovig meant she could continue school to become a nurse. She was on a free trial for a year, and now she's lucky to have coverage through her partner's health plan. For a while, she paid for it through student loans.
If it weren't for the coverage Sall has now, she wouldn't be able to afford the drug.
"I definitely had a point not that long ago that I was walking out of the pharmacy crying," she said. "My fingers are still crossed that it will eventually get covered."
Sall says she has tried one of the CGRP medications that the province has approved for coverage, but it didn't work for her.
Now that she has found a drug that is effective, she's afraid to try anything else as she finishes her studies.
"People don't really understand when you're trying different medications, you don't know what the effects are going to be," she said. "You don't know how it's going to impact your body."
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