Migraine in managed care

Migraine, one of the most common conditions reported by health plan members, receives inadequate attention in most managed care settings. The lack of a consistent and concerted approach to the management of patients with the most severe and intractable varieties of migraine is particularly obvious. Studies in our plan population have documented that the availability of effective new pharmacologic antimigraine agents could reduce both sick days and hospital visits. Development of new guidelines for management of migraine patients, including a formulary indicating the availability of agents that have been documented to be effective, will be a critical step in educating physicians as to the proper management of patients with migraine. Such guidelines should also provide specific criteria for referral. Studies that document positive outcomes of new migraine protocols will provide a basis for employer-driven expansion of migraine-related health-care coverage.