There are a large number of elctrical stimulation devices in the pain relief field which includes headache relief. ECOR is a stand out with its clinical data for migraines. However, a central problem is that the major competition for gammaCore are approved drugs, not other stimulation devices. MD's prescribe drugs as the first and second, and perhaps third line of therapy for migraines, changing between drugs for various reasons, such as none response to the therapies. For most MD's, electrical stimulation will be the last alternative that they prescribe. This situation is borne out by the sales data to date. There is a place in migraine therapy for gammaCore, but it may not be the basis for the company's success.
gammacore may have a greater chance for market success in treating acute airway construcion, such as occurs with acute episodes of asthma and anaphylaxis. The immediate response to gammaCore of patients in an ER setting who were refractory to drug therapy was impresive. Use of gammaCore for Covid-19 paietnts with breathing discomfort would fit into this as well. Since ER and ICU MD's are familiar with stimulation and they don't have time for slower actibg drugs, this might be a winner. The CE mark for gammaCore icludes this intended use, though the US FDA labeling does not. Unfortunately for shareholders, this early program was discontinued in favor of pursuit of migraines, which seems to have been a strategic blunder. Hopefully, the new CEO and management team will reexplore this opportunity.
