AbbVie announced that Quebec's Régie de l'assurance maladie du Québec (RAMQ) has listed QULIPTA (atogepant) in its formulary for the prevention of both chronic and episodic migraine. The Institut national d'excellence en santé et en services sociaux (INESSS) had previously published a positive recommendation for the public listing of QULIPTA in chronic migraine treatment on July 2, 2025.
Simplified Access Criteria
INESSS has finalized a class review of CGRP inhibitors that streamlines access to newer migraine treatments. The public reimbursement criteria have been modified from requiring failure of three oral generic preventive medication classes (anti-hypertensive, anti-depressant, and anti-epileptic) to only two failures. This change aligns with the updated Canadian Headache Society Migraine Prevention Guideline published in November 2024, which provides strong recommendations for anti-CGRP medications such as QULIPTA.
"I'm thrilled that patients living with chronic migraine in Quebec have greater access to a proven treatment option," said Dr. Elizabeth Leroux, Headache Neurologist. "Expanding access to therapies means we can better personalize care, improve quality of life, and offer renewed hope to those who have long struggled to find effective relief."
Clinical Significance for Migraine Management
Migraine affects an estimated 5 million Canadians and is characterized as a complex neurological disease with recurrent attacks lasting 4-72 hours. The condition presents with moderate to severe pain intensity, nausea, vomiting, photophobia, and phonophobia. Episodic migraine involves less than 15 headache days per month, while chronic migraine is defined as 15 or more headache days monthly.
Véronique Clément, General Manager of Migraine Quebec, emphasized the impact of expanded access: "Recognizing atogepant as a preventive option for chronic migraine, in addition to episodic migraine, represents real hope for people living with this disease. Improving access to innovative treatments contributes to an improvement in the quality of life of thousands of people across Quebec."
QULIPTA's Mechanism and Development
QULIPTA (atogepant) represents the first and only oral, small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist specifically developed for preventive treatment of both episodic and chronic migraine. The medication functions as a selective CGRP receptor antagonist that blocks the binding of CGRP to its receptor. CGRP is a neuropeptide that may play a role in migraine pathophysiology.
Rami Fayed, Vice President and General Manager of AbbVie Canada, noted the milestone's significance: "This additional option for patients living with chronic migraine in Quebec marks a significant milestone in our ongoing mission to deliver innovative therapies that address unmet medical needs. This positive recommendation from INESSS not only validates the clinical value of our migraine medicine but also reinforces our commitment to improving access for those living with chronic migraine."
Broader Impact on Migraine Care
The public listing will be followed by reimbursement through private plans, mirroring the public formulary structure. This expanded access provides Quebec patients with faster access to effective and well-tolerated anti-CGRP preventive medications, representing a significant advancement in personalized migraine care for the province's affected population.
