Eptinezumab (Vyepti)

Key Messages

• CADTH recommends that Vyepti be reimbursed by public drug plans for the prevention of episodic migraine (EM) or chronic migraine (CM) in adults who have had at least 4 migraine days per month if certain conditions are met.
• Vyepti should only be covered to treat patients who have tried at least 2 other types of oral treatments for the prevention of migraine. When it is first prescribed, the drug plans must also receive documented confirmation of the number of headache and migraine days that the patient is experiencing each month so that it is clear whether treatment with Vyepti is working.
• Vyepti should only be reimbursed if the patient is being cared for by a physician who has experience managing those with migraine headaches. To continue treatment with Vyepti, the physician must provide proof that treatment with Vyepti reduced the average number of migraine days per month by at least 50% since starting Vyepti, and that the reduction in the frequency of migraines is maintained. Vyepti will only be reimbursed for 6 months at a time and if the total treatment cost of Vyepti does not exceed the total cost of the lowest-cost reimbursed anti-calcitonin gene-related peptide (CGRP) comparator.