Qulipta's Reimbursement in Quebec and Its Implications for CGRP Market Expansion

The recent public reimbursement of QULIPTA® (atogepant) in Quebec marks a pivotal moment for the CGRP inhibitors market, signaling both regulatory progress and strategic opportunities for investors. As of September 2025, the Régie de l'assurance maladie du Québec (RAMQ) has expanded coverage of Qulipta to include both chronic and episodic migraine prevention, following a positive recommendation from the Institut national d'excellence en santé et en services sociaux (INESSS) in July 2025QULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. This decision simplifies access criteria by reducing the prior failure requirement for preventive medications from three to two classes, aligning with updated Canadian Headache Society (CHS) guidelinesQULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. For investors, this policy shift underscores Quebec's commitment to improving patient access to innovative therapies and highlights the growing acceptance of CGRP inhibitors as a cornerstone of migraine management.

Quebec's Policy Shift: A Catalyst for Market Expansion

Quebec's revised reimbursement framework for CGRP inhibitors reflects broader trends in migraine care. Previously, patients needed to fail three oral preventive medication classes to qualify for CGRP therapies. The new criteria, which require only two prior failures, are expected to accelerate adoption of drugs like Qulipta, particularly among chronic migraine sufferers who have historically faced barriers to effective treatmentQULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. This change is not isolated: INESSS also recommended eliminating annual renewals for CGRP inhibitors once efficacy is confirmed after six monthsA Major Breakthrough for Access to Anti-CGRP Treatments and Their Renewal in Migraine Care in Quebec^[6]. Such reforms reduce administrative burdens and incentivize long-term adherence, positioning Quebec as a leader in progressive migraine care.

From a financial perspective, the expansion of Qulipta's coverage is likely to drive sales growth for Teva Pharmaceuticals, its manufacturer. With public reimbursement now in place, private insurers are expected to follow suit, further broadening accessQULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. This dual public-private reimbursement model could replicate the success of monoclonal antibodies (mAbs) like erenumab and galcanezumab, which saw rapid uptake after similar policy changes in other provinces.

Market Dynamics: Growth, Competition, and Strategic Positioning

The CGRP inhibitors market is projected to grow at a compound annual growth rate (CAGR) of 12.13%, reaching USD 10.5 billion by 2034QULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. Preventive therapies dominate this market, accounting for over 76% of revenue, while oral gepants like Qulipta are gaining traction for their convenience compared to injectable mAbsQULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. North America, including Canada, remains the largest market, driven by high migraine prevalence and advanced healthcare infrastructureCGRP Inhibitors Market Report Highlights Investment Potential in 2025^[2]. However, the Asia-Pacific region is emerging as a high-growth area due to rising awareness and healthcare spendingCGRP Inhibitors Market Report Highlights Investment Potential in 2025^[2].

Qulipta's strategic positioning within this landscape hinges on its role as an oral CGRP antagonist. Unlike mAbs, which require injections, gepants offer patient-friendly dosing and are increasingly preferred for acute and preventive useCGRP Inhibitors Market Size, Growth, Industry Analysis 2032^[3]. Teva's ability to secure favorable reimbursement terms in Quebec—despite pharmacoeconomic concerns about Qulipta's cost-effectiveness in broader populationsPharmacoeconomic Review - Atogepant (Qulipta)^[4]—demonstrates the drug's perceived value in a market prioritizing patient outcomes.

Investment Timing: Capitalizing on a Shifting Landscape

For investors, the timing of entry into the CGRP sector appears favorable. Quebec's policy changes align with global trends toward earlier adoption of CGRP inhibitors, reducing the need for patients to exhaust older, less effective therapies. This shift is supported by updated clinical guidelines, such as the CHS's 2024 recommendations, which strongly endorse anti-CGRP therapiesQULIPTA® (atogepant) Now Publicly Reimbursed in Quebec for Chronic Migraine and CGRP Class Review Published^[1]. Additionally, the development of biosimilars and next-generation CGRP inhibitors by companies like Amgen and Eli Lilly could further expand market access while maintaining profit marginsCGRP Inhibitors Market - Report Scope^[5].

However, challenges remain. The pharmacoeconomic review of Qulipta notes that its cost-effectiveness is uncertain in the broader Health Canada–indicated population, suggesting pricing pressures may emergePharmacoeconomic Review - Atogepant (Qulipta)^[4]. Investors must also monitor reimbursement trends in other provinces and international markets, where access barriers persist.

Conclusion: A Strategic Inflection Point

Quebec's reimbursement of Qulipta represents more than a local policy update—it is a harbinger of broader market transformation. By lowering access barriers and aligning with clinical guidelines, Quebec has set a precedent that could influence other jurisdictions. For investors, this moment offers an opportunity to capitalize on a sector poised for sustained growth, provided companies like Teva can navigate pricing pressures and demonstrate long-term value. As the CGRP inhibitors market evolves, strategic positioning in oral gepants and partnerships with patient advocacy groups will be critical to maintaining competitive advantage.