Botox nearer approval as NHS treatment for chronic migraine

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The use of Botox to treat chronic migraine on the NHS has moved a step nearer.

Health watchdog the National Institute for Health and Clinical Excellence (NICE) yesterday published final draft guidance which recommends the anti-wrinkle jab for the condition.

NICE is advising the NHS whether the benefits of Botox, known chemically as botulinum toxin type A and manufactured by Allergan, for chronic migraine are value for money.

A spokeswoman said: “In February, NICE asked Allergan to provide more information and analyses as part of a public consultation on its draft recommendations.

“Allergan provided this information and NICE’s independent appraisal committee is now able to recommend Botox in the final draft guidance as a treatment option for chronic migraine in adults whose condition has not responded to taking at least three prior preventative medications and whose condition has been appropriately managed for medication overuse.”

The draft guidance recommends that injections should be stopped if the person’s headaches have not improved enough after two treatment cycles, or if the person’s “headache days” have reduced to fewer than 15 days a month over three consecutive months - this is because they will have a different type of migraine, called episodic migraine, which is not covered in Allergan’s licence for Botox.

NICE health technology evaluation centre director Professor Carole Longson, at, said: “Chronic migraines are extremely debilitating and can significantly affect a person’s quality of life.

“We are pleased that the committee has been able to recommend Botox as a preventative therapy for those adults whose headaches have not improved despite trying at least three other medications and whose headaches are not caused by medication overuse.

“We have published our final draft guidance so that registered stakeholders can highlight any factual errors or appeal against our provisional recommendations. We have not yet issued guidance to the NHS on the use of this drug.”

Once the final guidance has been published, the NHS must allocate funding for the use of Botox as defined in the guidance within three months.

Registered stakeholders wishing to appeal against the draft recommendations have until Friday May 25 to do so.

If no appeals are received, NICE hopes to publish its final guidance for the NHS in next month.

Chronic migraines – believed to affect 1.6 per cent of adults involve having headaches for at least 15 days a month over three months, eight of which are migraines.