Behind the World's Largest M&A in the New Year: The $10 Billion Migraine Market and the Popular Target CGRP

On May 10, Pfizer announced to acquire Biohaven Pharmaceutical Holding (Biohaven), a heavyweight player in the migraine field, for $16 billion in cash (a premium of 33%), which is the largest merger and acquisition in the pharmaceutical industry since the beginning of 202

Affected by this news, as of the close of.

Upon completion of the transaction, Pfizer will acquire Biohaven's calcitonin gene-related peptide (CGRP) program, including: rimegepant (US trade name: Nurtec ODT; EU trade name: Vydura); Zavegepant intended for acute intranasal spray treatment of migraine , and is being developed as an oral softgel for chronic migraine prevention; and 5 preclinical programs targeting CG.

Among them, rimegepant, an oral CGRPR antagonist, has the highest market share in the.

The migraine market has huge demand and limited treatment drugs

Migraine is a common chronic neurovascular disease characterized by recurrent, severe headache with one or both throbbing, which can be combined with photophobia, sound-phobia, hallucinations, nausea, and vomiti.

About 1 billion people worldwide suffer from migraine, of which 75% are women, and the World Health Organization ranks migraine as one of the top 10 disabling medical diseas.

Since triptans, no breakthrough migraine drugs have been market.

The emerging target CGRP has become a hot research and development direction

With the deepening of the research on the pathological mechanism of migraine, it was found that the release level of calcitonin gene-related peptide (CGRP) was significantly increased during migraine attacks, and it was positively correlated with the degree of headac.

As a potent vasodilator neuropeptide, CGRP exists in both peripheral and central neurons and can play a role in pain transmissi.

To date, seven migraine therapies targeting the CGRP/CGRPR pathway have been approved for marketing worldwide, including monoclonal antibodies targeting CGRPR and CGRP, as well as CGRP receptor antagonist dru.

TableGlobally marketed migraine drugs targeting the CGRP/CGRPR pathway, source: public information

Aimovig development process

Aimovig is a fully human monoclonal antibody drug targeting CGRPR jointly developed by Novartis and Amg.

In May 2018, Aimovig was approved by the FDA, becoming the world's first approved antibody drug targeting the CGRP receptor;

Approved for listing in the EU in July 2018;

In April 2022, the marketing application of Aimovig injection was accepted by CDE for the preventive treatment of migraine in adul.

market sales

Ajovy is the second FDA-approved anti-CGRP fully human monoclonal antibody drug, with sales revenue of US$176 million in 2021;

Eli Lilly's Emgality's sales revenue in 2021 is as high as $572 million, surpassing Novartis/Amgen's Aimovig;

Allergan/AbbVie's Ubrelvy, as an oral small molecule drug, has seen significant sales growth in recent years, with sales revenue reaching $552 million in 2021;

Lundbeck's Vyepti 2021 sales revenue of DKK 492 million;

AbbVie's Qulipta is approved for listing in 2021, and its specific sales have not been announc.

Excellent Nurtec test data

Biohaven's Nurtec is the first and only FDA-approved CGRPR antagonist in a fast-acting orally disintegrating tablet (ODT) dosage form, which disperses immediately in the oral cavity, does not require water, and is convenient to take anytime, anywhe.

In February this year, the Nurtec Phase III study for acute migraine treatment in Asia Pacific also achieved positive results: the primary endpoints of pain relief and most distressing symptom (MBS) relief were achieved within 2 hours of treatment with Nurt.

Biohaven's other drug Zavegepant, a third-generation high-affinity, high-selectivity, and uniquely structured small molecule CGRPR antagonist, submitted a marketing application to the FDA in March this year as a drug for the treatment of acute migraine in adul.

Oral CGRP(R) drugs have huge growth potential

Oral CGRP(R)-targeted drugs are currently the fastest growing class of migraine drugs in the US alo.

FigureAnnual sales graph of various migraine drugs, source: Biohaven official website

Compared with the old triptans used to treat migraine in the past, CGRP(R) drugs have the advantages of better efficacy and better safety, so the prospects are quite promisi.

A review published in Nature estimates that the global migraine market size is expected to exceed $11 billion in 2027, and CGRP(R) drugs alone will capture more than $5 billion in sal.

The prevalence of migraine in China is 3%, with more than 130 million patien.

It is the country with the largest number of migraine sufferers in the wor.

Therefore, the market potential in China is hu.

At present, except for Novartis/Amgen's Erenumab marketing application that has been accepted, no domestic companies have corresponding projects in clinical development, which means that the domestic migraine market is still a blue ocean, and its potential remains to be explor.

Looking back to Pfizer, Pfizer, which achieved a surge in revenue in 2021 with the new crown vaccine + oral drug dividends, has also changed its previous prudent attitude in mergers and acquisitions and began to buy, buy, b.

In March 2021, Pfizer acquired Arena for $7 billion to complement its inflammation and immunology business pipeline;

In August 2021, Pfizer acquired Trillium Therapeutics for $26 billion, harvesting two early-stage clinical-stage oncology drugs, including the star target CD4

The migraine drugs from the acquisition of Biohaven will be added to the internal medicine business pipeli.

In 2021, the revenue of these three business lines will account for 6%, 15%, and 12%, respectively, and none of the three are strong areas for Pfiz.

It can be seen that in the "post-epidemic" era, Pfizer is working hard to strengthen the layout of its short-board busine.

How to follow up, Yaodu will continue to pay attenti.

References:

Pfizer to Acquire Biohaven Pharmaceutica.

Retrieved 2022-05-10, from https:// Pfizer to Acquire Biohaven Pharmaceutica.

Retrieved 2022-05-10, from https://"New progress in the US$10 billion migraine market, Novartis CGRPR monoclonal antibody enters the Chinese market"; CPhi Pharmaceutical Online, April 8, 2022;

"Sudden! Pfizer's $16 Billion Acquisition of Biohaven, Begins Big M&A of the Year"; MedTrend, May 10, 202