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With approval of a new migraine therapy, Eli Lilly has become the third drug company angling for dominance in what could become a multibillion-dollar market for preventing debilitating headaches. But because none of the three medicines is clearly better than another, the contenders are taking a novel approach to competition: giving drugs away for free.

Lilly’s treatment, called Emgality, is an injected medicine that has proved to reduce the number of migraine days patients experience each month. Doctors say its effects are virtually identical to recently approved treatments from Teva Pharmaceutical and the partnership of Amgen and Novartis, and all three drugs carry a list price of $6,900 per year.

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And so each company is working to build brand loyalty by providing the drug for free to patients with private insurance. Under Lilly’s program, patients prescribed Emgality can get the treatment for free for up to 12 months, and the company is working to get initial doses of the drug distributed to doctor’s offices, allowing migraine sufferers to get started on the treatment immediately after prescription.

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