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12 July 2018

Migraine Advocacy and Access to Care

For women and men with migraine, the only thing better than making a headache stop is preventing it altogether. New drugs known as CGRP inhibitors may allow just that – if patients can access them.

While patients see new drugs as the chance for a better quality of life, health plans may instead see them as a threat to their bottom line. So insurers are constructing barriers to limit the drugs’ accessibility.
Some health plans may place CGRP inhibitors on a specialty tier, which deters access by requiring patients to pay a hefty portion of the cost from their own pockets. Asking migraine patients to make exorbitant out-of-pocket payments can force them to choose between treatment and basic necessities. Patients deserve to have proper coverage for the medications they need. 

Others may use prior authorization, where migraine patients must wait while their health insurer approves their doctor’s prescription. Sometimes prior authorization includes step therapy, when health plans force patients to prove that less expensive therapies don’t work before they agree to cover the prescribed drug. 

Migraine leaves patients at its whim, denying them the ability to plan ahead with confidence, attend work and social functions, and be there for family and friends. Asking these patients to “fail first” on insurer-preferred drugs instead of accessing breakthrough treatment directly is unacceptable.

And then some health plans may impose prescribing restrictionsHealth plans want to reduce costs by limiting which physicians can prescribe new CGRP inhibitors. But not all patients can access a headache specialist. Any physician who knows the patient and his/her condition well should be allowed to prescribe the necessary medication.

These tactics make patients wait for treatment, leaving them vulnerable to migraine headaches and keeping them from a medication that could improve their quality of life.

Patients and health care providers must work together to keep health plans’ profit-driven policies from delaying the treatment that migraine patients need. These are the four key messages to take away with you:

  • Migraine won't wait. 
  • Failure is not a treatment option.
  • Don't price migraine patients out of treatment.
  • Let the doctor that knows my migraine treat my migraine.

Here's how you can help!

50 state network, cgrp, migraine, 50-state network

50-State Network is a grassroots advocacy organization working to share the patient perspective for State and Federal health policy and regulation. It is a free program and activities are all voluntary. Members of this network are patients living with chronic illness who are advocating to improve the healthcare system. This starts in your own communities, State Capitols and eventually on the national stage on Capitol Hill in Washington, D.C.

I share why being a migraine patient advocate is important to me and how you can begin your advocacy journey. I encourage migraine patients from all across the country who are comfortable sharing their story to join the 50-State Network today. We are in particular need of advocates from the following states:

New Hampshire
New Mexico
South Dakota

Click the image below to join!

50 state network, cgrp, migraine

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