Is Migraine in the Forefront of the Battle Against Unresolved Pain?

Today’s guest blog comes from Gudarz Davar, M.D., platform leader for the neuroscience product development team at Lilly.

The ongoing U.S. opioid crisis has brought a necessary spotlight to one of the greatest challenges facing our healthcare system: unresolved pain and the need for disruptive innovative approaches to address it. It seems we receive almost daily reminders of the vast societal toll this gap in care presents to our society. However, with a growing wave of innovation in the treatment and management of acute and chronic pain, we have an opportunity to shift the dialogue and overcome barriers that plague those living with it - and those treating it.

Perhaps one of the most immediate and critical opportunities exists in the field of migraine treatment. This may come as a surprise, but one of the most prevalent causes of under-treated recurrent pain in America is migraine, impacting 30 million adults a year. Often dismissed as “just a headache,” migraine is a neurological disease characterized by recurrent episodes of severe headache accompanied by other symptoms including nausea, vomiting, sensitivity to light and sound, and changes in vision. In some cases, a migraine attack can last up to three days.

In most instances, traditional preventative medicines for migraine weren’t developed specifically for the disease and may be associated with intolerable side effects. As a result, people with migraine continue to experience debilitating consequences to their life, both physical and psychological. Studies show that they are more likely to miss work, family and social events than those who do not experience migraine.

Migraine not only presents a significant physical burden, but an economic one. According to the Medical Expenditures Panel Survey, migraine costs the U.S. health system more than $56 billion a year, exceeding the annual cost of stroke and equaling the annual cost of respiratory disease. From a global perspective, migraine is the second leading cause of disability worldwide.

Work productivity for people living with migraine is also greatly affected - not just from absences - but from those experiencing a migraine attack who try to “power through,” leaving them short of their best and their employer looking for more. Add to this the immense strain migraine puts on our healthcare system, including more than 1.2 million visits to U.S. emergency rooms annually, what you have are the makings of a significant public health challenge.

Despite the clear physical, economic and emotional toll of the disease, innovation has been scarce, leaving people with migraine with limited treatment options that sometimes work, and sometimes don’t. Furthermore, as we see in many other pain and headache disorders, the stigma people living with migraine face within the healthcare system can lead to delayed diagnosis, misdiagnosis, bias in treatment and decreased effectiveness of care.

We have a responsibility to rethink unresolved pain in America, including a new level of focus on tackling migraine. Fortunately, we are moving in the right direction. We are witnessing significant scientific advances in migraine treatment, including the recent introduction of the calcitonin gene-related peptide (CGRP)-inhibitors for migraine prevention. And for the first time in a long while, there is significant investment in the science, education and disease awareness needed to reframe migraine within the healthcare system and to legitimize its impact within society. 

To capitalize on this wave of innovation and attention, we need to accelerate a real-world shift that ensures those living with migraine are properly diagnosed, properly treated and most importantly, properly respected. No longer can the disease and those living with it be relegated to a dark room or the sidelines as a result of long-held, entrenched thinking.

By redefining the way we think about migraine, enabling an environment of innovation and advancing a shift in treatment and education, we can position migraine at the forefront of our country’s fight to address unresolved pain.  

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