Amgen and Novartis’ Aimovig, first in its new class of migraine meds, hit the scene in May. Patients were ready and waiting for it.

"There is clearly a lot of demand for the product and our expert talked about the companies being ‘overwhelmed’ in trying to keep up with the initial interest," Credit Suisse analyst Vamil Divan wrote to clients after talking with Dr. Christopher Gottschalk, a migraine specialist from Yale University.

Amgen, for its part, was counting on an initial surge from "pent-up demand" for its first-mover advantage for Aimovig. "There’s a lot of buzz in the field," company VP of Development Rob Lenz said ahead of the approval.

The thing is, payers were also ready for Aimovig, with lead PBM Express Scripts, for one, putting in place a prior authorization program it said would "help payers get the most value for the money they spend." And warnings from payers about high list prices likely factored into Amgen’s decision to price the drug at $6,900, below the $8,000 to $10,000 range industry watchers expected.

Right now, Amgen and Novartis are doling out Aimovig for free, "so we are not yet seeing the impact of potential payer hurdles to getting on therapy," Divan noted. "However, there are clearly a large number of patients reaching out to their neurologists and their primary care physicians and inquiring about this new treatment option," he added.

It’s good news for Amgen, which has a short window to snap up a share in a wide-open market before competition hits. Approvals for drugs in Aimovig’s class—which targets the calcitonin gene-related peptide pathway—are expected soon from Eli Lilly and Teva, and others including Alder and Allergan have their own in the works, too.

A couple of those meds might even threaten Aimovig from a convenience perspective, Divan pointed out. "Our expert viewed the quarterly dosing option that Teva’s fremanezumab may have as a potentially important differentiating factor," he wrote, what with Amgen and Lilly’s drugs requiring monthly at-home injections.

Alder’s eptinezumab, though, may be even more compelling for doctors, as it’s "also dosed quarterly but given by a healthcare professional as an intravenous infusion," Divan wrote.

"Our expert prefers this approach as it would keep him in touch with his patient on a regular basis, give him an opportunity to see how the patient is doing overall, and also help promote proper compliance with therapy," he said.

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