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An estimated 466,316 patients in New York are not receiving guideline-appropriate preventive migraine care from their primary care provider

86.6%gap rate among active Medicare migraine PCPs
700PCPs never prescribed CGRP
108prescribing CGRPs
808 total active prescribers

How New York compares

New York's gap rate of 86.6% is consistent with the national pattern of 90.4%. Of the 808 primary care physicians in New York actively treating Medicare patients with migraine, 700 have never written a CGRP prescription. This is not a New York-specific failure — it is a national crisis that New York is experiencing alongside 47 other states.

Metro breakdown

6 major metropolitan areas

CityPatients blockedActive prescribersNever prescribed CGRPGap %
Rochester~11K666293.9%
Brooklyn~63K784861.5%
New York~42K554581.8%
Bronx~33K312683.9%
Williamsville1616100%
Syracuse~6K171376.5%

Not in one of these cities? Find your county's numbers →

What this means for patients

A patient with frequent migraine who sees their primary care physician in New York has a 86.6% chance that their doctor has never prescribed a CGRP-targeting therapy. This is not a reflection of physician knowledge or intent — it is the predictable consequence of prior authorization requirements that make CGRP prescribing administratively prohibitive in primary care.

About the data

Based on CMS Medicare Part D prescribing data — the only publicly available provider-level prescribing dataset in the United States. Active prescriber = 20+ triptan claims in the observation period. Medicare patients represent a subset of the total migraine population; the true gap is likely larger. Full methodology →

Getting CGRPs approved in New York

Prior authorization burden is the primary structural explanation for this gap. The Headache Vault PA Engine navigates New York payer requirements — covering all major commercial insurers and Medicare Advantage plans. Free for all clinicians, no account required.

Run a PA — free →

New York Medical Society members: this data and tool are free to share with your members. All data on this page is CC BY 4.0.

Citation

Doty A. Migraine Prescribing Gap in New York.
The Headache Vault; June 2026.
Available at: https://headachevault.com/research/prescribing-gap/new-york/
Licensed CC BY 4.0.
Data: CMS Medicare Part D Prescriber Public Use Files, 2022-2023.
← National report
✓ CC BY 4.0