A recent article in the Journal of Head and Face Pain outlines strategies for migraine treatment absent of in-person visits, and describes ways health insurance companies can remove barriers to migraine care during the coronavirus disease 2019 (COVID-19) pandemic.

“Our common goal as health care providers is to maximize the health and safety of our patients,” authors write. They continue, “successful management of migraine with avoidance of in?person clinic and emergency department visits further benefits the current urgent societal goal of maintaining social distance to contain the COVID?19 pandemic.”

Even with available treatment, migraine accounts for thousands of dollars of lost productivity. In 2018, excess medical and pharmacy treatment costs for employees with migraine averaged to almost $2000 a year. Those treated for migraine also had an average 2.2 more sick days per year, averaging out to approximately $600 in wages and benefits.

In the article, researchers called on insurers to remove requests for prior authorizations and step therapy requirements for migraine therapies, and reviewed classes of different medicine categories to aid providers in their shift to telehealth services during COVID-19.

“Migraine can worsen during times of stress, so having available options that bypass insurance hurdles and can be administered at home without patient training is imperative,” authors argue.

Telemedicine has proven to be a cost-effective and convenient method of providing headache care, historically achieving similar satisfaction rates and outcomes reported from in-person visits. Implementation of telehealth allows individuals living in rural areas, perhaps miles from the nearest headache specialists, to have a clinical encounter over their smartphone. As telehealth parity laws vary per state prohibiting some aspects of care, authors point out telephone visits could function as practical alternatives.

“Patients no longer have to miss work, drive long distances, spend money on gas, tolls, and parking lots, and wait prolonged periods in a doctor’s office to be seen, where they might also be exposed to communicable diseases,” authors said, adding they hope widespread use of telehealth will remain after the pandemic has resolved.

COVID-19 continues to take an economic toll on the United States. As a result, pharmacological treatment access may be limited for migraineurs who lost their job and health insurance, or who can no longer afford their migraine medications.


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