The PBAC has recommended the Authority Required (STREAMLINED) PBS listing of galcanezumab for the treatment of chronic migraine in patients who have experienced an inadequate response, intolerance or a contraindication to at least three prophylactic migraine medications.

The positive recommendation from the July PBAC meeting follows a rejection earlier this year of another CGRP-targeted monoclonal antibody.

Erenumab was not recommended for PBS listing at the March meeting as the Committee considered the magnitude of the clinical benefit, and the claim of noninferior efficacy compared with Botox, were uncertain.

It will be reconsidered at the November PBAC meeting.

As reported in the limbic earlier this year, there is enthusiasm around the promise of the monoclonal antibodies.

The July PBAC meeting outcomes summary said it considered galcanezumab was an alternative treatment to botulinum toxin type A for patients with chronic migraine and provided a similar reduction in migraine headache days.

“The PBAC considered the cost minimisation analysis should be based on equi-effective doses of 120 mg galcanezumab every 30 days and 164IU of Botox every 12 weeks over 2 years of treatment.”

“Additionally, the PBAC considered it would be appropriate for galcanezumab and Botox to be combined in the same subsidisation caps under a Risk Sharing Arrangement.”