The migraine therapy market has heated up over the past few years with the emergence of many new acute and preventive medications. However, patient uptake hasn’t matched rising market competition.

Despite a slew of prescription options and widespread advertising pushes, most patients are sticking with over-the-counter (OTC) remedies rather than trying new preventive medications, according to Phreesia Life Sciences’ survey results collected from more than 4,000 patients checking in for their doctors’ appointments in July 2021. Only about half of those living with migraine (52%) have tried acute therapy, and just 37% have investigated preventive therapy, the survey found. And among patients who have tried preventive medications for migraine, 39% said they no longer took them.

These low adoption rates highlight the need for more migraine-drug awareness and suggest that pharma marketers should explore new strategies to boost patient uptake.

Migraine Is Widespread, But Expertise Is Limited

Migraine takes a toll on patients’ daily lives, with 74% of surveyed patients reporting that their migraine has had a moderate-to-great impact on their day-to-day functioning, and 53% reporting that they have had to miss work or school because of their symptoms. However, the good news is that patients are asking their doctors for help—76% of surveyed patients reported having talked with their healthcare providers about migraine treatment options, and within that group, 64% and 54% discussed acute medications and preventive treatments, respectively.

But even though a majority of migraine patients are turning to their doctors for guidance, they may not be getting the most up-to-date information on available treatments. More than 39 million Americans live with migraine,1 yet there are only about 2,000 certified headache specialists in the U.S.,2 according to the American Migraine Foundation. That specialty shortage means that many patients look for migraine relief from their primary care providers who may not be fully informed about the many new treatment options for migraine.

In addition to a dearth of clinical experts, migraine is also an invisible illness: Those living with the disease may appear completely healthy between attacks, which can make them more vulnerable to being misunderstood, explains Lawrence Newman, MD, Chair of the American Migraine Foundation.

“Those living with this disabling disease often find themselves and their disease stigmatized,” Dr. Newman says. “They are misunderstood, misjudged, misdiagnosed, and mistreated by their friends, families, spouses, colleagues, co-workers, employers, and physicians.”

Consumer Brand Awareness is Low

Despite patients’ willingness to learn more about their migraine treatment options, pharma marketers have their work cut out for them when it comes to brand awareness and patient education. Drugmakers that are producing new preventive migraine therapies—many of which belong to the calcitonin gene-related peptide (CGRP) inhibitor drug class—have invested heavily in direct-to-consumer advertising but still need to do more to boost brand recognition.

Among surveyed patients, nearly half (47%) couldn’t remember a single preventive migraine brand name, and the leading brand patients did recall—Topamax—is an older drug that was approved for migraine in 2004. Improving consumers’ brand awareness could mean big gains for preventive-therapy drugmakers, from getting migraine patients new to CGRP options to try them to persuading others to switch to CGRP medications from their current preventive migraine treatment.

Doctor-Patient Communication, Self-Advocacy Drive Medication Uptake

More than half of surveyed patients (53%) said a recommendation from their doctor would pique their interest in trying a new preventive migraine drug. Other influencing factors included more information on side effects (36%), drug cost (28%), and efficacy (28%). As a top patient resource for trusted information, it’s essential that doctors are made aware of the range of prescription migraine therapies and encouraged to recommend them to their patients. Among surveyed patients who had tried a preventive migraine treatment, 44% said they did so because their doctor suggested it.

Patient self-advocacy is another powerful tool pharma marketers can leverage to stand out in the crowded market space and increase brand adoption. Migraine patients should take the lead in discussing their condition with their healthcare providers, rather than accept living with the disease, Dr. Newman says. “By advocating for themselves, people living with migraine can take control of the narrative, fight the stigma, inform the misinformed, and become active partners in their care and treatment,” he adds.

To equip patients with the tools and resources they need for self-advocacy, consider reaching them at the point of care before their doctors’ appointments. Indeed, when exploring migraine treatment options, 36% of surveyed patients consider information that describes how migraine medication works as one of the top three resources they find most helpful to them.

Partnering with advocacy organizations that can support patients with the tools they need to combat stigma, provide up-to-date facts about the disease and the best available treatments, and supply them with access to local disease specialists can also help support patients, Dr. Newman says.

Adherence Rates Matter, Too

While getting patients started on preventive migraine treatments is a big focus area for drug companies, addressing low medication adherence rates also should be a top priority.

Among surveyed patients who reported trying preventive medications for migraine, 39% said they no longer took them. However, patients aren’t dropping their medications because their symptoms have disappeared—31% of those who had stopped taking preventive migraine drugs said they still experienced migraine eight or more days each month, and 83% said that migraine still had a moderate-to-great impact on their quality of life.

Clearly, patient satisfaction with preventive migraine drugs needs to be improved. A little more than half of surveyed patients who had taken Eli Lilly’s Emgality, Biohaven’s Nurtec ODT, Amgen’s Aimovig, or Teva’s Ajovy reported being satisfied with them, but the percentages of patients who were completely satisfied with those drugs were much lower. One factor fueling this dissatisfaction might be patient concerns about side effects, the leading reason (28%) surveyed patients who had tried preventive migraine medications stopped taking them.

What Marketers Can Do

Convincing migraine patients who haven’t talked to their doctors or who feel misunderstood by them to speak up about their symptoms should be a top priority, especially for those who work on acute migraine therapies.

To support those conversations, create messaging that reassures migraine patients that their symptoms are legitimate and encourages them to talk to their doctors about treatments that go beyond OTC remedies. Reaching patients right before their medical appointments and equipping them with migraine education and support tools can empower them to take charge of their therapeutic journey and discuss treatments options with their doctor.

And when it comes to retaining current patients, ensure that those who take preventive migraine medications are aware of available support services for side effects as well as medication and drug-cost information.





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