White Paper
Migraine is often a debilitating disease—it's the second most common cause of disability around the world, and among young women it takes the top spot.1 Globally, migraine impacts a billion people and causes millions of lost work days.2 In the United States alone, 38 million people experience migraines every year, creating a financial burden of $27 billion.3,4 Despite its high prevalence, migraine is a severely undertreated disease.
Unmet clinical needs are high, even as the market for migraine drugs grows. In 2021, the sale of migraine drugs in the United States topped $5 billion,5 and new treatment modalities and preventive treatments came on the market, yet two-thirds of suitable patients never get preventive care for their migraine disorder.6
There are myriad opportunities for innovative biopharma companies to connect patients with better treatment options. As a chronic condition with an often-challenging patient journey, migraine presents several pain points where biopharma digital solutions can create value for stakeholders.
Prevention is key in the patient journey, and successful preventive brands should seek to use digital to address hurdles that limit patients from accessing prophylactic treatments and on-demand drugs.
But no player has yet to stake a claim in digital for migraine. That has left patients to manage a complex disease on their own.
"The current state of digital in migraine care is inactive. There is little digital awareness among patients and especially among providers. Patients are not given recommendations for tools to comprehensively or efficiently track migraine details and triggers, adding an additional burden for them to seek out and trial the few existing tools. There's a tremendous unmet need, and an opportunity to evolve with the patient over the course of their journey."
– Kristin Zyga, Senior Director, Market Research at BrightInsight
1 Steiner TJ, Stovner LJ, Jensen R, et al. Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. The Journal of Headache and Pain. Dec. 2. 2020.
2 Abbvie. The math of migraine. June 2, 2021.
3 Kamin, D. OTC: Wrapping Your Mind Around Migraine Medications. UC San Diego Health Newsroom. April 25, 2019.
4 Ailani J, Burch RC, Robbins MS; the Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. June 23, 2021.
5 Evaluate Pharma: Migraine Report. Indication Profile. June 24, 2022.
6 Lipton RB, Bigal ME, Diamond M, et al; AMPP Advisory Group. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. Jan 30, 2007.
The migraine patient journey is complex, with varying degrees of treatment efficacy and multiple therapeutic options. During the long, often frustrating journey patients experience hardships including isolation, relationship impacts, the stigma around lost work and depression.
It can take years to get a diagnosis and many patients never get an appropriate treatment. In the U.S. there is a severe lack of certified headache specialists—six states have no headache specialists at all. Two-thirds of patients who meet criteria for being offered or considering a prophylactic therapy never receive one11, and the majority who do drop off due to perceived efficacy or tolerability.
Additionally, there are several new therapies for migraine, including calcitonin gene-related peptide (CGRP) receptor antagonists, serotonin agonists, neuromodulatory devices, and intravenous anti-CGRP ligand monoclonal antibodies, which have complex and resource intensive prior authorization processes that often require patients to piece together medication history from various sources, such as pharmacy databases, past physician records, and handwritten notes. Patients may need to progress through a process of trial and error to obtain a treatment that works, and repeat that process when it stops working.12
"The natural course of the disease is that medications work, then stop working, so it continuously requires adjustment."
– Mark, PCP
"My doctor initially gave me a paper sheet to fill out whenever I had a migraine, but it was too small and hard to use, so I made my own version in excel so I could give them more data. They ended up taking my template and giving it to other patients to use."
– Rachel, patient
7 Peres MFP, Swerts DB, de Oliveira AB, et al. Migraine patients’ journey until a tertiary headache center: an observational study. The Journal of Headache and Pain. August 15, 2019.
8 BrightInsight expert interview.
9 Hepp Z, Dodick DW, Varon SF, et al. Persistence and switching patterns of oral migraine prophylactic medications among patients with chronic migraine: A retrospective claims analysis. Cephalalgia. April 2017.
10 Blumenfeld AM, Bloudek LM, Becker WJ, et al.. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: results from the second international burden of migraine study (IBMS-II). Headache. April 2013.
11 Lipton R, Bigal M, Freitag F, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. November 2011.
12 Ailani J, Burch RC, Robbins MS; the Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. June 23, 2021.
To date, there is no suitable digital tool to solve the myriad of challenges patients with migraine face. Market research shows that patients want resources to help them manage migraines, including education, support services, coaching, and digital documentation with data sharing, but clinicians have little to offer them. That’s why we’ve configured the BrightInsight Disease Management Solution for migraine to act as a one stop shop for migraine patients throughout the patient journey.
Our comprehensive patient app can be configured for new patients who are recently diagnosed or not yet diagnosed and need extensive tracking for migraine onset and potential triggers, or experienced patients who are managing different challenges, such as identifying new therapies as previous ones become less effective due to tolerance or resistance.
"What I need is more of a heads up—the goal is to stop it from progressing to a massive migraine, so that it is just a 'normal' headache. So there would be less worry, less isolation, I could still engage. Less loss of time. If I can’t cure it, I want to be able to control it."
– Nikole, patient
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