Generic bests Botox for migraine: MDsTopiramate, the generic name for Ortho-McNeil/Janssen-Cilag's Topamax, is the sales leader among drugs approved for chronic migraine. So, it came as no surprise that a Decision Resources survey of neurologists found that the highest percentage of neurologists (55%) and MCO pharmacy directors (40%) rated it the most efficacious current therapy for the condition.
However, neurologists reported being only moderately satisfied with topiramate's accessibility. The drug went generic in 2009, and insurance coverage may vary depending on whether plans have yet to reevaluate tiering and grant it more favorable placement.
Topiramate and onabotulinumtoxinA (Allergan's Botox), which won approval for the indication last October, are the only prophylactic therapies to demonstrate efficacy against chronic migraine in multiple placebo-controlled clinical trials.
Decision Resources expects the Botox approval to spur diagnosis and treatment of the