Acute migraine treatment accepted for use on NHS in Scotland

9th May, 2023: Pfizer Ltd announced that the Scottish Medicines Consortium (SMC) has accepted Vydura ®  (rimegepant) for restricted use for the treatment of acute migraine with or without aura, for patients who have had inadequate symptom relief after trials of at least two triptans or in whom triptans are contraindicated or not tolerated; and have inadequate pain relief with non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol.[i]

Rimegepant is an oral lyophilisate (dissolving wafer) and is the first oral calcitonin gene-related peptide (CGRP) receptor antagonist for the acute treatment of migraine to be accepted for use by the Scottish Medicines Consortium (SMC).

Migraine can be debilitating to those affected,[ii] with one in seven people in the UK living with migraines.2 Migraine most often begins at puberty and most affects those aged between 35 and 45 years.[iii] Migraines are two to three times more common in women, with hormonal changes being a potential trigger.2

Migraines can have a significant impact on the daily lives of people who suffer with them. Today’s decision, to recommend an orally dissolvable wafer and expand migraine treatment options, is a positive step towards helping to improve care for eligible patients in Scotland.

Dr David Watson, Hamilton Medical Group (NHS Grampian)

Migraine can be a severe and painful long-term health condition, with a wide variety of symptoms, often including head pain, vomiting, nausea, disturbed vision, fatigue and sensitivity to light, sound and smells.[iv] Symptoms vary between individuals and attacks and can have a major impact on the lives of those living with migraine, with sufferers often experiencing other long-term mental or physical health conditions.2

Toby Cousens, Head of Hospital and Internal Medicine, Pfizer UK said: “There is an unmet medical need to support people living with migraine and today’s decision is good news for eligible patients in Scotland. As well as the physical impact of symptoms, migraine can have a negative impact on the professional and personal lives of those living with it.  We’re committed to supporting people living with migraine and will continue to work with the SMC and other health bodies in the UK to help further improve access and care.”

It is estimated that up to 43 million workdays are lost each year in the UK to migraine-related absenteeism.2 In addition, estimates state that Migraine may cost the UK economy between £6 billion and £10 billion per year in total healthcare and productivity costs. 2

Pfizer is planning a resubmission to the SMC for the review of rimegepant in the prevention of episodic migraine in adults who have at least four migraine attacks per month, after it was not recommended for use.

[i] Scottish Medicines Consortium (SMC).

[ii] The Migraine Trust.  State of the Migraine Nation Dismissed for too long, 2021. Available at: Dismissed-for-too-long_Recommendations-to-improve-migraine-care-in-the-UK.pdf. Accessed: May 2023

[iii] WHO. Headache disorders. Headache disorders (  Accessed: May 2023

[iv] The Migraine Trust. What is Migraine? Available at: Accessed: May 2023