Nurtec vs. Qulipta: Understanding the List Price
Nurtec (rimegepant) and Qulipta (atogepant) are both premium-priced, brand-name medications that belong to a class of drugs called CGRP inhibitors. CGRP stands for calcitonin gene-related peptide, a protein involved in migraine attacks. By blocking the CGRP receptor, these drugs can prevent or stop a migraine. However, their costs differ, and the one that is 'more expensive' depends heavily on how it is used and whether the patient has insurance.
Nurtec ODT (Rimegepant) Pricing
Nurtec ODT is a 75 mg orally disintegrating tablet used for both the acute treatment of migraine and the preventive treatment of episodic migraine.
- For Acute Treatment: For episodic relief, patients may use up to eight pills per month as needed. The average retail price for an eight-tablet pack is around $1,300 to $1,326, which may last a month or more, depending on usage.
- For Preventive Treatment: For migraine prevention, the dose is one tablet every other day. This requires 15 to 16 pills per month, bringing the monthly cost to approximately $2,600 without insurance.
Qulipta (Atogepant) Pricing
Qulipta comes as a standard tablet and is approved specifically for the preventive treatment of episodic and chronic migraine.
- For Preventive Treatment: Qulipta is taken daily. The average retail price for a 30-day supply ranges from approximately $1,490 to nearly $1,500 without insurance.
The Impact of Dosing and Use on Cost
When comparing the list price alone, it's clear that the monthly cost of Nurtec for prevention is significantly higher than that of Qulipta. However, Nurtec can also be used as a more affordable, as-needed acute treatment, making its monthly cost highly variable. The most expensive drug depends on the prescribed treatment plan.
How Insurance Coverage Affects Your Final Price
The full retail price of these medications is not what most patients ultimately pay. Insurance coverage is the single most important factor determining your out-of-pocket costs, which can vary dramatically.
- Prior Authorization: Some insurers may require specific documentation and a prior authorization process before covering these expensive, brand-name medications.
- Formulary Status: Coverage depends on your specific health plan. It is common for insurers to cover one medication but not the other, or to place them on a higher-tier co-pay. Some Medicare Advantage plans, for example, have been noted to deny coverage for Qulipta.
- Savings Programs: For commercially insured patients, both Nurtec and Qulipta offer manufacturer savings programs or copay cards. These programs can often reduce a patient's monthly out-of-pocket cost to as little as $0, but restrictions apply.
Navigating Costs with Patient Assistance and Savings Programs
Even without commercial insurance, there are ways to manage the high cost of these drugs. Patients should explore the following options:
- Manufacturer Patient Assistance Programs: Both AbbVie (Qulipta) and Pfizer (Nurtec) offer patient assistance programs for qualifying uninsured or underinsured individuals. These programs may provide the medication for free based on eligibility criteria.
- Prescription Discount Cards: Services like SingleCare and GoodRx offer free coupons that can lower the cash price of both medications at participating pharmacies.
- Non-Commercial Support: Organizations such as the Patient Access Network Foundation and the HealthWell Foundation also offer assistance for managing copays and deductibles.
- Medicare Extra Help: For Medicare beneficiaries, Extra Help is available for those with low income and resources to cover costs.
Cost Comparison Table
| Feature | Nurtec (for Prevention) | Qulipta (for Prevention) |
|---|---|---|
| Dosing Schedule | 1 tablet every other day | 1 tablet every day |
| Approximate Monthly Cost (W/O Insurance) | ~$2,600 (15-16 tablets) | ~$1,500 (30 tablets) |
| Approximate Annual Cost (W/O Insurance) | ~$31,200 | ~$18,000 |
| Available Savings Program | Yes, for commercially insured | Yes, for commercially insured |
| Potential Patient Cost (W/ Copay Card) | As little as $0 per month | As little as $0 per month |
| Financial Assistance | Yes, via Pfizer Patient Assistance Program | Yes, via myAbbVie Assist |
| Use | Acute & preventive | Preventive only |
Which is More Cost-Effective? Weighing All Factors
For patients seeking preventive treatment alone, the list price of Qulipta appears less expensive on a monthly basis. However, an indirect treatment comparison published in NeurologyLive suggested that Qulipta might be more cost-effective per additional responder when comparing its preventive efficacy to Nurtec's.
Ultimately, the 'more expensive' drug is not determined by its list price but by the individual patient's insurance coverage, specific plan formulary, and eligibility for savings programs. For commercially insured patients, both manufacturers strive to bring out-of-pocket costs down to a minimum. For uninsured patients, the list price difference is substantial, but patient assistance programs could offer both medications at little to no cost for those who qualify.
Conclusion: The Bottom Line on Nurtec and Qulipta Costs
Comparing which is more expensive, Nurtec or Qulipta, is not a simple matter of looking at the retail price. For migraine prevention, Nurtec's every-other-day dosing results in a significantly higher potential monthly cost without insurance compared to Qulipta's daily regimen. However, with the right insurance and manufacturer savings programs, both medications can be highly affordable for many patients. The determining factors are the specific treatment plan (acute vs. preventive), insurance coverage, and eligibility for financial assistance. Patients should consult their healthcare provider and insurance company to determine their likely out-of-pocket expenses.
For more information on comparing these migraine treatments, check out the GoodRx comparison page.
