Ajovy Webcast Summary

Dr. Susan Hutchinson joined Dr. Jack Schim for a live Webcast on Thursday evening, October 25th, to discuss Ajovy, the second CGRP monoclonal Antibody approved for migraine prevention. It is an injection and offers the option of quarterly or monthly dosing. Results can be seen as early as 1 week in some patients. This new category of CGRP monoclonal antibodies is target specific for migraine, very tolerated, and highly effective for most migraine sufferers. An exciting time in history with this break-through treatment for migraine prevention.

Is the new Ajovy for migraine prevention better than Aimovig?

There have not been any studies comparing Ajovy with Aimovig. This new category of CGRP monoclonal antibodies is an incredible break-through for migraine prevention. Experience in the “real world” apart from clinical trials may help us answer your question. Significantly, both Aimovig and Ajovy have favorable side-effect profiles, are well-tolerated, and quite effective (as early as 1 week in some patients) in clinical trials.

Some patients may feel one works better than another just like some patients prefer Sumatriptan to Rizatriptan vs others prefer Rizatriptan to Sumatriptan. Treatment needs to be individualized to each patient. We are here to help develop your individualized migraine treatment plan.

To make an appointment, please call 949-861-8717.

Fall 2018 Newsletter

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Dear Patient,

We are pleased to announce that a second CGRP Monoclonal Antibody, Ajovy, was approved by the FDA on 9/14/18 for the prevention of migraine in adults. Like Aimovig, it is a subcutaneous injection. Both are well-tolerated and have been shown to be highly effective in clinical trials.

Ajovy is available as a pre-filled syringe vs the auto-injector with Aimovig. Ajovy offers the option of a quarterly (every 3 months) dosing. However, it requires 3 injections for the quarterly dosing. A monthly single subcutaneous injection is also available. For some patients, the quarterly dosing could be done as part of an office visit every 3 months and may be more convenient than the monthly self-injection.

Is one better than the other? The short answer is that we don’t know. There have not been any comparison trials. All trials with this new category of migraine prevention with CGRP monoclonal antibodies were conducted with the active drug vs placebo.


Who is a candidate for a CGRP monoclonal antibody (CGRP mAB)?

Any adult migraine sufferer who has 4 or more disabling monthly migraine days would be a candidate. Most insurance companies will require a failure or intolerance to at least 2 standard oral migraine preventives. Currently, this new category for migraine prevention is only approved for adults 18 and over in the US. There is not enough data to know if this new category is safe for pregnancy and lactation.
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We encourage you to make an appointment to explore this new preventive option for migraine. We may be able to give you the 1st injection in the office as part of your visit.

We are entering a new era of headache medicine with the advent of migraine specific preventive treatment that is effective and well-tolerated. You deserve to live a life as free of migraine as possible. We are here to help.

For more information, go to www.Aimovig.com and www.Ajovy.com


Dr.  Susan Hutchinson, Dr. Molly Rossknecht, & Staff

Orange County Migraine & Headache Center


Is there evidence that use of the computer, kindle, and cell phone contribute to migraine? Is the light emitted from these devices troublesome?

Yes, there is evidence that high energy (HEV) blue wave or “blue light” that flickers from our electronic devices can aggravate migraines. This “blue light” can disrupt our sleep patterns at night, can cause eye strain, and cause oxidative stress all of which are associated with migraine.  Treatment includes avoiding use of these devices for 3-4 hours before bedtime, wearing blue light blocking glasses while using these devices, and installing blue light blocking screens.

To make an appointment, please call 949-861-8717.

What Is CGRP?

CGRP stands for Calcitonin Gene-Related Peptide.  It is a neuropeptide located in neurons (nerve cells) and smooth muscle throughout the part of the nervous system that is part of the migraine process. When a migraine trigger occurs in a susceptible individual, CGRP levels increase and this increase is felt to be major part of the pathophysiology of migraine. Research has demonstrated elevated CGRP during migraine attacks. In addition, research has demonstrated relief of a migraine attack when a CGRP blocking medication is given. This blocking of CGRP is the mechanism of action of the new category of CGRP Monoclonal Antibodies that are now coming to market for the prevention of migraine. The first one available, Aimovig, blocks CGRP activity at the receptor site. To learn more, go to www.Aimovig.com and www.scienceofmigraine.com

To find out if this new preventive treatment makes sense for you, please schedule a visit at our office. We are very excited about this new treatment.

To make an appointment, please call 949-861-8717.

How do I know if the new CGRP preventive injection is for me?

The new category of CGRP Monoclonal Antibodies for migraine prevention is ideally suited for anyone suffering from migraine at least 4 days per month. The first one is now available and is called Aimovig. It is approved for adults 18 and over. It is not recommended in women who are breast-feeding or pregnant. Most likely insurance companies will require failure or intolerance of at least 2 standard oral migraine preventives. The best next step would be to come in for an appointment so we can determine if Aimovig would be a good next step for you.

To make an appointment, please call 949-861-8717.

Important Update: Aimovig for Migraine Prevention

According to Amgen Pharmaceutical, the overwhelming response to get Aimovig injection for migraine prevention has far exceeded their expectations. As a result, it is taking up to 4 weeks for patients to get their first shipment of Aimovig 70 mg injection once the paperwork has been processed. Our office began submitting Aimovig request electronically about 3 weeks ago to expedite processing of the prescription and enrollment form. Despite our electronic submission process, it is still taking 4 weeks for patients to receive the Aimovig.

Our office reached out to Amgen to see if there is another option while patients are waiting.  We found out that we can send a prescription in to Newport Lido Pharmacy for processing. Newport Lido will do the prior authorization and if approved, patients may be able to get Aimovig for as low as $5 copay. The Aimovig can be shipped to you or you can pick it up from Newport Lido.  Sending the prescription to Newport Lido does not take away the processing for the 2 free months that will come from enrollment in the Aimovig Ally program.

Another option is to go to www. GoodRx.com and get the best cash price for your first injection. My staff informed me Aimovig could be purchased for less than $600 at Costco and a few other retail pharmacies. Some of you may have Health Savings Accounts (HSAs) and be able to use that to pay for your first Aimovig injection.

Some of you have expressed concern about the $25 processing fee that you paid our office.  To clarify, this is to cover the staff’s time in the enrollment process and all the follow-up time tracking down orders now that Amgen is experiencing delays due to the overwhelming response.  Amgen takes full responsibility for the delay that is occurring. For more information, visit the Aimovig Facebook page or see their own message below this announcement.

In summary, Aimovig is and will continue to be a good treatment option for migraine prevention for many of you. We look forward to a new era in migraine treatment.


Dr. Susan Hutchinson

July 3, 2018


Amgen Apology Per Their Facebook:

We’re excited about the launch of Aimovig, and judging by the overwhelming requests we’ve received, so are you. We know the wait times for some of you have been less than ideal, so we want to take a moment to let you know exactly how we are addressing this. Due to high demand, we have increased the size of our Aimovig Ally™ team, so we can process your requests faster. While we are upgrading our team, please bear with us. Once prescribed, getting you Aimovig as quickly as possible continues to be our number one priority.

Aimovig (CGRP Monoclonal Antibody) Update

Good news: Amgen/Novartis is offering 2 months of injectable Aimovig to all who qualify (adults with commercial insurance) once a service request form is completed by both the patient and the prescriber office.

To access the patient form that needs to be completed, go here: https://www.aimovighcp.com/-/media/project/aimovighcp/files/service_request_form.ashx

Once this opens, click on the service request form. Complete the top half in full including all your demographics and your insurance information. The insurance information must be filled in-we have been told it is not sufficient to simply fax in a copy of the insurance card. Also you need to sign and date. Electronic signatures are not accepted.

Once completed and signed you can fax to us at 949-861-8719 or send as an attachment to our email info@ocmigraine.org

You will need to call and make arrangement to pay $25.00 as a processing fee to cover our time in completing our part of this form and faxing in and following up when additional information requested.

We recommend an office visit approximately 1 week after your 2nd injection to document efficacy and to help with insurance approval. As long as our office is documenting that we are trying to get insurance, Amgen/Novartis will continue to provide the monthly 70 mg injection at a small copay fee. We are very pleased with the strong commitment that Amgen/Novartis has made to make available this preventive treatment to almost everyone for 1 full year.

You are strongly encouraged to go to www.aimovig.com to learn more about this first CGRP Monoclonal Antibody that has now come to market for the prevention of episodic and chronic migraine.

In good health,

Drs. Susan Hutchinson & Molly Rossknecht
Orange County Migraine & Headache Center
May 28,

Aimovig Approved for Migraine Prevention

Aimovig is the first CGRP (Calcitonin gene-related peptide) monoclonal antibody to be FDA approved for preventive treatment of migraine in adults. This announcement took place on 5/17/18. The recommended dosage is 70 mg once monthly given as a subcutaneous injection in the abdomen, thigh, or upper arm.

Details of the best way to prescribe this for all of you interested are being worked out this week by Amgen/Novartis as well as our office. It appears there will be a service request form that needs to be completed and signed by both the patient and the prescribing provider. Two months of free treatment is offered as one of the options. For more information go to www.aimovig.com

Please don’t call the office to ask the staff questions as our office is working out details of how best to get you started on this break-through preventive treatment for migraine. There is no need to rush in for a visit or samples as the free samples will most likely be shipped directly to you for the first 2 months. Many of you are comfortable with self-administered subcutaneous injection and won’t need to come into the office for your first treatment. However, a follow-up visit during the 2 month trial  will be important to pursue insurance coverage for continued use beyond the 2 month free trial.

Please stay tuned. I am very pleased that 2 months of free samples can be an option for almost everyone interested. We will make available the service request form for completion as soon as possible. Hopefully, it can be provided as a link on our website. You would complete your part and return to us electronically or by fax or hard copy in person or mail.  The prescriber would complete her part and the request faxed in. A separate visit to get started may not be necessary if you are up-to-date with your visits and have already discussed CGRP Monoclonal Antibody treatment with one of our providers. There will be a processing fee to cover our time to enroll you in this free 2 month trial. Details on this to follow.

To learn more about this exciting break-through for migraine prevention, please visit www.aimovig.com


Continued good health,


Dr. Susan Hutchinson
Dr. Molly Rossknecht
Orange County Migraine & Headache Center
May 21, 2018

OC Migraine & Headache Center Angels 5K & 1 Mile Fun Run Was A Blast!

We had a great time at the Angels 5K run which benefited the Angels Charities which help children throughout Orange County! Dr. Hutchinson took 3rd place in her age group! We appreciate everyone who came out and joined us! We look forward to next year’s event!