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It’s Time to Remove Access Barriers for Migraine Patients

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Headache disorders and migraine disease are much more common than believed. More than 1 in 10 Americans live with migraine disease, and migraine patients are the fourth-highest users of the ER.

Lindsay Lawrence Videnieks

Executive Director, Headache and Migraine Policy Forum

This month we recognize National Migraine & Headache Awareness Month and call for open access to patient care. Health insurance company cost-cutting tactics like step therapy and prior authorization are two common barriers to patient access, especially for infused or injected medications. These tactics limit access to important prescriptions and treatments and require doctors to waste time arguing with health insurance companies instead of spending time with their patients. These short-sighted practices also increase costs, as patients experiencing excruciating pain and lacking necessary treatment often seek emergency care.

Migraine attacks are much more intense than common headaches, and the road to diagnosis and proper treatment is long. Patients often spend years searching for treatments that can consistently relieve their attacks with minimal side effects. You can imagine how frustrating it is for patients when an insurer or pharmacy benefit manager removes a patient’s medication from their formulary and takes away access to an important treatment that took years to discover. This practice is called non-medical switching, and it interferes with the patient-provider relationship and puts patients at risk of adverse reactions. Migraine patients often find that using more than one drug, called combination therapy, reduces the number of headache days or migraine attacks. The FDA approves of marketing combination therapy, but this is yet another safe and effective therapy that insurers prohibit, creating additional access issues for migraine patients.

Open access to care for migraine patients

Access to telemedicine increased significantly during the pandemic. Telemedicine is helping to bridge the gap in access to care; however, most patients recognize that it is a supplement, rather than a replacement, to traditional in-person care. As we adjust to new post-pandemic norms, it’s vital that policymakers and insurers provide access to a balanced approach to care, allowing patients to meet with providers based on what is best for their individual circumstances.

Headache disorders and migraine attacks impact others in addition to the person experiencing pain. This disabling disease adversely affects people’s ability to care for their families and contribute to their communities. Migraine attacks also impact the workplace through lost productivity, absenteeism, and resulting economic losses. Migraine disease imposes estimated costs of roughly $78 billion annually. In a patient-centered care environment, insurers and government healthcare programs would allow patients living with headache disorders to explore all available treatments with their providers, including non-pharmacologic options like neuromodulation devices, until they find the strategy that works best for them. As migraine patients and caregivers continue to navigate their treatment journey, open access to care and treatment will help better manage the disease, saving time, money, pain, and allowing patients to fully engage in life.

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