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The number one prescriber to migraine patients are migraine patients. In other words, they self prescribe. This is because the majority of migraine patients never see a physician. In fact even if they consulted a physician at one time or another, only a small minority of patients have even received the diagnosis of migraine headache from any physician. Many are misdiagnosed with tension headache or recurrent sinus headaches. A recent study suggests that patients with moderate to severe recurrent sinus headaches actually suffer from migraine headaches. Neurologists only see a small percentage of overall migraine headache patients.
Many migraine patients have seen a physician in the past but do not currently see a physician. When asked why, their number one reason is “lack of effective treatment”. Unfortunately many physicians practice a form of prescribing for migraine headaches known as “step care”. In this system the cheaper medications are prescribed first and the newer, more expensive medications are prescribed only if the patient returns and states the older medications did not work. While the less expensive medications may cost less, the ultimate cost to an average individual is actually higher than the more expensive medications. In fact, the newer agents have been shown to be cost effective and result in higher levels of patient satisfaction compared to prior therapies.