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What Stakeholders Value in Migraine Medicines

December 16, 2020

Decreases in migraine frequency as well as severity were the most meaningful outcome measures of a migraine medication’s value as judged by patients, providers, and other stakeholders, according to a study published online in Headache: The Journal of Head and Face Pain.

“Value‐based contracts linking medication payments to predefined performance metrics aim to promote value through aligned incentives and shared risk between manufacturers and payers,” researchers wrote. “The emergence of new and expensive pharmaceuticals for migraine presents an opportunity for value‐based contract development.”

To identify which outcomes are most relevant to stakeholders, researchers conducted a Dephi survey involving a total 82 patients, providers, payers, employers, and pharmaceutical company representatives. Stakeholders gauged the importance and feasibility of 15 migraine-related outcomes.

When asked to choose the most meaningful outcomes, 88% of participants selected decrease in migraine frequency and 80% selected decrease in migraine severity, according to the study.

The outcomes with the most overall agreement in the survey were a decrease in migraine frequency, which 100% of stakeholders agreed was important, followed by an increased ability to resume normal activities, which drew 96% agreement.

Meanwhile, the measures providers, payers, and pharmaceutical company representatives rated the most feasible to collect were decrease in emergency department/urgent care visits and decrease in migraine frequency, researchers reported.

Jolynn Tumolo


Swart ECS, Good CB, Henderson R, Manolis C, Yanta C, Parekh N, Neilson LM. Identifying Outcome Measures for Migraine Value-Based Contracting Using the Delphi Method. Headache. 2020 Nov;60(10):2139-2151. doi: 10.1111/head.13978. Epub 2020 Sep 30. PMID: 32997806.

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