Adequate Treatment Rate in Migraine
What it is
Studies consistently show that a large majority of people with migraine are not receiving adequate treatment. The American Migraine Prevalence and Prevention (AMPP) study found that only 12% of people with migraine who were eligible for preventive therapy were receiving it. Acute therapy gaps are similarly large: a significant proportion of people with migraine rely on over-the-counter medications exclusively, even when prescription options are indicated.
How it works
The AMPP study (Lipton et al., 2007) established foundational treatment gap figures. Preventive therapy eligibility was defined as 4 or more migraine days per month with disability (MIDAS Grade II or higher) or meeting other clinical criteria. Among those eligible, only 12% received preventive pharmacotherapy. Barriers include underdiagnosis, physician unfamiliarity with current guidelines, insurance restrictions, and patient perception that migraine is not medically treatable.
What patients need to know
Most people with migraine — even those who see a doctor regularly — are not getting treatments that could meaningfully help them. Many people do not know that prescription options exist, or they have been told their headaches are just stress.
Prior authorization
The treatment gap provides policy context for why payer restrictions are particularly damaging in migraine: of the fraction of patients who actually reach a prescriber, a substantial additional fraction face prior authorization barriers. For HOH advocacy: even without PA barriers, most eligible patients are not receiving adequate care; PA barriers make a bad situation worse.
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