The Role of Copay Assistance in Overcoming Cost Access Barriers for Ubrelvy and Nurtec

Ubrelvy (Ubrogepant) and Nurtec (Rimegepant) are competitive calcitonin gene-related peptide receptor antagonists (CGRPs) used for the acute treatment of migraines. However, Nurtec is used also for episodic migraine prevention. Both medications are relatively new to the pharmaceutical market with Ubrelvy, manufactured by AbbVie, taking up 31% of the market share and Nurtec, produced by Biohaven Pharmaceuticals, taking up 11% and growing. According to the third edition of the International Classification of Headache Disorders (ICHD-3), CGRPs are considered third-line treatment based on efficacy, tolerability, safety, cost, and availability. If reoccurring migraines have been established in patients without effective treatment, then CGRPs can be used sooner. However, a predicament can arise when patients are prescribed Ubrelvy or Nurtec and face the issue of affordability.

Currently, the Wholesale Acquisition Cost (WAC) for a month's supply of Ubrelvy is $937.13. For Nurtec, the WAC for a blister pack of 8 is $919.28. The problem lies in the fact that healthcare providers may be hesitant to prescribe them due to the cost factor. Not only are patients met with a cost access barrier, but there are also other social determinants of health that affect them from receiving these medications. A copay assistance card helps uninsured and insured patients afford expensive medications by covering part or all the patient's deductible and copay. This benefits patients because it provides financial assistance to retrieve the appropriate medication and reduces their total out-of-pocket expenses. In effect, the card offsets the price of the medication and covers medications, like Ubrelvy and Nurtec, that do not have generic versions.

In addition, there are prescription assistance programs (PAPs), such as myAbbVie Assist, Change HealthCare, and NiceRx, that help determine whether patients qualify for reduced-cost or free medications from the pharmaceutical company. Medicare ExtraHelp is a similar patient assistance program (PAP); however, this particular program exclusively caters to individuals with Medicare or Medicare Part D prescription drug coverage. Generally, PAPs support patients who are treated by a licensed healthcare provider, have limited or no health insurance coverage, and demonstrated financial need. Whether utilizing a copay assistance card or a patient assistance program (PAP), both share the common objective of ensuring that patients have access to safe and effective medications at little to no cost.