The National Health Care Institute has advised the Minister of Health, Welfare and Sport (VWS) to extend the List 2 conditions for atogepant (Aquipta®) for patients with episodic migraine (EM). This medicine is already being reimbursed for certain patients with chronic migraine since 1 December 2024. Atogepant is already in the Medicine Reimbursement System (GVS) with additional conditions for reimbursement. If the Minister adopts our advice, these reimbursement conditions will be extended.
Current state of affairs: advisory report sent to the Minister
The National Health Care Institute has sent this advice to the Minister of Health, Welfare and Sport (VWS). The Minister makes the final decision whether or not to extend the conditions of reimbursement.
Atogepant is intended for people with migraines
Atogepant is the active substance. The brand name is Aquipta®. The medicinal product is a tablet that is ingested daily. The medicinal product is a CGRP inhibitor, as are erenumab, fremanezumab and galcanezumab. However, those three medicinal products are administered differently, with an injection under the skin.
The medicine can be used for people with chronic migraine. These patients suffer from headaches at least 15 days per month, of which at least 8 days are migraine days. Atogepant can also be used for people with episodic migraine. They have headaches for less than 15 days a month, of which at least 4 days are migraine days.
Advice from the National Health Care Institute on the expansion of the reimbursement conditions for atogepant
The National Health Care Institute advises the Minister of Health, Welfare and Sport to expand the reimbursement conditions for atogepant (Aquipta®) for patients with episodic migraine. These are the so-called List 2 conditions.
For more information on the GVS and lists 1A, 1B and 2, see the page on ‘Reimbursement of outpatient medicines’.
Expansion of reimbursement conditions for atogepant (Aquipta®)
Since 1 December 2024, atogepant has already been included in the GVS for patients with chronic migraine. With the advice of 22 October 2025, we advise the Minister to extend the List 2 conditions for the indication of episodic migraine as follows:
Only for an insured person aged 18 years and older with episodic migraine after exclusion of medication overuse headache and failure of prophylactic treatment with
- at least 2 months of topiramate or valproate in adequate doses and
- at least 2 attempts with botulin toxin A (6 months) according to the PREEMPT protocol, unless it is an insured person with chronic migraine who was already treated with a CGRP inhibitor under a managed access programme on 17 September 2021.
More information or questions?
If you have any questions about this advice, please send your question to the National Health Care Institute via warcg@zinl.nl. If you have questions about the reimbursement of a medicinal product, the personal expenses or whether you should pay a contribution, please ask your health insurance provider.
How did the advice come about?
The Scientific Advisory Board (WAR) advises the National Health Care Institute about the assessment. The Minister makes the final decision whether or not to reimburse the medicinal product from the basic healthcare package.
Explanation about the reimbursement of medicinal products
Atogepant is an extramural drug. ‘Extramural’ means medicines for home use that can be obtained at the pharmacy with a prescription from a physician. They are only reimbursed from the basic healthcare package if they are listed in the GVS.