A new generation of migraine‑prevention tablets is transforming treatment options for tens of thousands of people across England, with prescriptions more than tripling in just one year, according to new NHS figures.
In 2025, around 22,800 people were prescribed atogepant or rimegepant by their GPs – a dramatic rise from the previous year following NICE approval of both medicines. This number is likely higher overall, as the figures do not include prescriptions issued by hospitals or specialist headache clinics.
The approval of these treatments has widened access for people whose migraines have not responded to traditional preventive therapies.
Migraine is far more than a severe headache. Symptoms can include:
- Intense, throbbing pain
- Nausea and vomiting
- Extreme sensitivity to light, sound and smells
- Fatigue
- Attacks lasting up to several days
The condition is more common in women and is one of the leading causes of disability worldwide. Its impact extends beyond health, costing the UK economy more than £4 billion in lost working days each year. Research from The Migraine Trust suggests the figure could reach £9 billion when accounting for “presenteeism”, where people continue working despite symptoms but cannot perform at their best.
A survey of 2,000 people found that 89% reported that migraine had affected their mental health, and one in three had experienced suicidal thoughts because of the condition.
Until recently, preventive treatments for migraine included:
- Antidepressants
- Antiepileptic drugs
- Beta‑blockers
These medicines were not designed for migraine, could cause significant side effects, and often became less effective over time.
Atogepant and rimegepant work differently. They block CGRP (calcitonin gene‑related peptide) — a chemical associated with triggering migraine attacks. While CGRP‑targeting treatments have been available previously as injections or infusions, these medicines are the first to offer the same mechanism in tablet form.
NICE recommendations:
- Rimegepant approved in 2023 for treating migraine and preventing episodic attacks (4–14 migraines per month).
- Atogepant approved in 2024 for preventing both episodic and chronic migraine (15+ headache days per month).
- Both can be used when at least three other preventive options have failed.
In 2025 14,500 were prescribed Rimegepant, 9,300 were prescribed atogepant, as well as some patients receiving both medicines at different times.
While access is expanding, many patients still face:
- Long waiting times, as tablets often need to be initiated by specialists
- Regional variation in availability
- Non‑response in some patients, requiring alternative therapies
Experts say that identifying clinical “green flags” – strong indicators that symptoms are due to migraine rather than another condition – could give GPs greater confidence to diagnose and prescribe preventive treatments earlier. This may help patients progress more quickly through first‑line options and access specialist medicines such as atogepant and rimegepant sooner.
Helen Knight, Director of Medicines Evaluation at NICE, said:
“These tablets are already transforming the lives of thousands of people with migraine in England, and the rapid uptake is very encouraging. NICE is committed to helping get the best care to patients and ensure clinically and cost-effective medicines are available to those who need them. We hope this continued momentum means even more people can benefit in the months ahead.”
For many people, the new tablets represent a major shift in how migraine is managed – providing a more targeted option that can reduce attack frequency and improve quality of life.
As uptake continues to rise, clinicians hope the treatments will help reduce the burden of migraine on individuals, families and the wider economy.
Image credit: iStock
