Botox (botulinum toxin type A), best known for treating wrinkles associated with aging, could soon be a treatment option in both England and Wales.
"Ask your physician about appropriate therapy for treating your migraines."
The news follows the recommendation by the National Institute for Health and Clinical Excellence (NICE) that the National Health Service (NHS) permit the treatment for adults who suffer from more than 15 migraines a month.
Carole Longson, director of the Health Technology Evaluation Centre at NICE, noted that chronic migraines can be extremely debilitating and can significantly affect a person's quality of life. She said she is pleased that the committee has recommended Botox as a preventative therapy for adults with headaches that have not improved, after trying at least three other medications and whose headaches are not caused by medication overuse.
A public consultation to discuss the draft guidelines is planned for June 7.
NICE has not yet issued formal guidance on the use of Botox for chronic migraines. NHS had previously asked the agency for advice regarding the benefits of Botox, as well as the cost effectiveness of the treatment.
The treatment is already approved by the FDA to treat migraines in the United States.
Drugmaker Allergan estimates that a single administration of Botox would cost about $117, which would include injection of the drug to between 31 and 39 sites around the head and the back of the neck. The company recommends 12-week treatment cycles.
For the entire 12-week therapy, the cost would be $558.
The draft guidance suggests stopping treatment if migraines do not improve after two treatment cycles, or when the number of headache days is reduced to fewer than 15 a month over three consecutive months. This is because Botox is only licensed to treat chronic migraines in adults, defined as 15 or more headaches each month.
Following published final guidance, most likely next month, NHS must allocate funding for the use of Botox as defined in the guidance for three months. Until then, decisions are made locally as to whether Botox will be funded for patients with chronic migraines.