North Dakota
Medicare Migraine Prescribing Gap Report
94.7%
of primary care physicians actively prescribing triptans to Medicare patients in North Dakota have never prescribed a CGRP medication
How North Dakota compares
North Dakota's 94.7% gap is 4.3 points above the national average of 90.4%. 36 of 38 primary care physicians with an active Medicare migraine patient panel have never written a CGRP prescription.
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 →
What drives the gap
Prior authorization burden is the primary structural explanation for this gap. The Headache Vault's PA Engine helps primary care physicians navigate CGRP prior authorizations in North Dakota and all 50 states — free for all clinicians.
Try the PA Engine →Citation
Doty A. Migraine Prescribing Gap in North Dakota. The Headache Vault; 2026. Available at: https://headachevault.com/research/prescribing-gap/north-dakota/ Licensed CC BY 4.0. Data: CMS Medicare Part D Prescriber Public Use Files, 2022-2023.