Biohaven Pharmaceutical Holding Company Ltd. and Pfizer Inc. announced that the parties have completed the collaboration transaction between the two companies. The transaction agreements, including Pfizer’s commercialization of rimegepant and zavegepant outside of the US, have become effective following the receipt of required regulatory approvals and the satisfaction of other customary conditions, and BHVN shares have been issued to Pfizer. Biohaven will continue to lead research and development globally and retain rights to the US market.

In connection with the closing of the equity purchase and effectiveness of the strategic transaction, Pfizer made an upfront payment to Biohaven of $500 million, consisting of $150 million cash and $350 million in the purchase of Biohaven equity. At close, Pfizer will own 3% of Biohaven. Biohaven is also eligible to receive up to $740 million in future milestones. In addition to the tiered double-digit royalties owed to Biohaven on net sales outside of the US, Pfizer will compensate Biohaven for a pro-rata share of certain of its sales-based milestone obligations owed to Bristol-Myers Squibb Company (BMS), and for the related royalties on net sales outside of the US owed under Biohaven’s license and funding agreements with BMS and Royalty Pharma.

"The successful closing of our collaboration agreements represent an important and exciting step in expanding the impact of rimegepant to people outside the US with migraine,” said Nick Lagunowich, global president, Pfizer Internal Medicine. "We are enthusiastic about working with the Biohaven team to bring this valuable new treatment option to the millions of people across the globe suffering from migraine.”

Rimegepant is commercialized as Nurtec ODT in the US and is the only oral CGRP (calcitonin gene-related peptide) receptor antagonist approved for both the acute and preventive treatment of migraine in adults. An application for the approval of rimegepant is currently under review by the European Medicines Agency with a decision expected in the first half of 2022. Rimegepant is already approved for the acute treatment of migraine in Kuwait and the United Arab Emirates, and for the acute and preventive treatment of migraine in Israel. Zavegepant is a third generation, high affinity, selective and structurally unique, small molecule CGRP receptor antagonist delivered in an intranasal spray which recently achieved positive Phase 3 topline data in its second pivotal clinical trial for the acute treatment of migraine in adults. Zavegepant, if approved, would be the first intranasal CGRP receptor antagonist for the acute treatment of migraine in adults. Intranasal treatments like zavegepant offer additional potential benefits including ultra-rapid speed of onset and a non-oral delivery for patients who experience significant nausea or vomiting.

Vlad Coric M.D., chairman and CEO of Biohaven commented, “Together we hope to establish a world-class migraine business that can deliver on our promise of providing new treatment options for people living with this debilitating disease.” Dr. Coric added, “We are excited to collaborate with Pfizer given their global footprint and experience in the treatment of pain and in Women's Health, which we believe may help establish rimegepant as a leading novel treatment of migraine.”

More than one billion people suffer from migraine worldwide, of which 75 per cent are women. The World Health Organization classifies migraine as one of the 10 most disabling medical illnesses. Migraine is characterized by debilitating headache attacks lasting four to 72 hours with multiple symptoms, including pulsating headaches of moderate to severe pain intensity that can be associated with nausea or vomiting, and/or sensitivity to sound (phonophobia) and sensitivity to light (photophobia). There is a large unmet need for new acute and preventive treatments, as a significant portion of migraine patients are unsatisfied with current standard of care migraine treatments due to a lack of efficacy or safety or tolerability burden.

Rimegepant targets a key component of migraine by reversibly blocking CGRP receptors, thereby inhibiting the biologic cascade that results in a migraine attack. Rimegepant was approved by the US Food and Drug Administration (FDA) under the trade name Nurtec ODT for the acute treatment of migraine in February 2020 and for the preventive treatment of episodic migraine in May 2021. A single dose of 75 mg Nurtec ODT provides fast pain relief, significant pain reduction and return to normal function, and has a lasting effect of up to 48 hours in many patients. Nurtec ODT is taken orally as needed, up to 18 doses/month to stop migraine attacks or taken every other day to help prevent migraine attacks and reduce the number of monthly migraine days. Nurtec ODT does not have addiction potential and is not associated with medication overuse headache or rebound headache.

Zavegepant is a third generation, high affinity, selective and structurally unique, small molecule CGRP receptor antagonist from Biohaven's NOJECTION Migraine Platform and the only CGRP receptor antagonist in clinical development with both intranasal and oral formulations. The efficacy and safety of intranasal zavegepant was shown in two pivotal clinical trials with statistical superiority to placebo on the coprimary endpoints. Previously the efficacy and safety of intranasal zavegepant was shown in a randomized controlled phase 2/3 dose-ranging trial with more than 1000 patients treated. In December 2021, zavegepant pivotal data showed statistical superiority to placebo on a total of 15 consecutive, prespecified primary and secondary outcome measures in the acute treatment of migraine. Topline results showed ultra-rapid pain relief at the earliest measured time point of 15 minutes, return to function at 30 minutes, 2 hour freedom from pain and freedom from patients' most bothersome symptom (either nausea, photophobia or phonophobia) and sustained efficacy through 48 hours after a single intranasal dose. Biohaven plans to file a New Drug Application for zavegepant with the US Food and Drug Administration in 1Q2022.