To ask the Minister of Health for an update on the commissioning of (i) Atogepant for preventative use; and (ii) Rimegepant for preventative and acute use, for the treatment of migraines.

My Department has a formal link with the National Institute for Health and Care Excellence (NICE) under which NICE Technology Appraisals are reviewed locally for their legal and policy applicability here, and where found to be applicable, they are endorsed for implementation within Health and Social Care (HSC) organisations. In practice, this means that treatments that have been recommended by NICE for routine use in the NHS in England are also available in Northern Ireland. This process is relevant to the commissioning of treatments for migraines.

NICE are currently considering the use of atogepant (Aquipta®) for preventing migraine and a final determination is expected to be published in May 2024. Under the extant HSC Managed Entry process, my Department may look to decisions made by other relevant UK bodies to inform commissioning decisions in the absence of a NICE determination.

In this regard, Atogepant (Aquipta®) is already accepted for use for the prophylaxis of migraine in adults who have at least 4 migraine days per month in line with advice from the Scottish Medicines Consortium (SMC2259). This position will be reviewed following publication of final NICE guidance, to inform long term commissioning decisions.

In Northern Ireland, rimegepant (Vydura®) is accepted for use as an option for the acute treatment of migraine with or without aura in adults (NICE TA919) and as an option for preventing episodic migraine in adults who have at least 4 and fewer than 15 migraine attacks per month, only if at least 3 preventative treatments have not worked (TA906).