About 40 million people in the United States have migraine, a condition characterized by severe throbbing head pain, nausea, vomiting and sensitivity to light and sound, according to the American Migraine Foundation. 

The third most common health condition in the world, migraine is an expensive disorder to treat, with an annual economic burden of about $78 billion in the United States, with annual direct and indirect costs of between $8,500 and $9,500 for each patient with migraine. Prime Therapeutics (Prime) clients had over $1.25 billion in migraine drug expenditures in 2025, according to internal data. 

“Migraine is a complex condition with symptoms far beyond simply a headache,” said Marci Chodroff, MD, FACP, vice president, medical director. “At Prime, we want to make sure patients experience a smooth, seamless path to treatment. That’s why we’re committed to staying on top of the latest developments in migraine treatment options and offering solutions geared toward improving health outcomes and driving down drug costs so patients can focus on living, not just managing their condition.”  

Staying atop the latest treatment options

Migraine treatment has been an area of immense innovation in recent years — especially in the development of oral calcitonin gene-related peptide (CGRP) receptor antagonists, also known as gepants. These medications block the protein CGRP from attaching to its receptors throughout the body, stopping pain signals and reducing inflammation.   

Prime’s clinical teams continuously monitor the drug development pipeline and publish their analyses of the latest drug approvals and forthcoming FDA decisions, which include any developments in migraine therapy. This helps healthcare payers make informed coverage decisions about the latest treatment options. 

“We know that most individuals who have migraine try multiple different therapies before they find their best fit,” said Maryam Tabatabai, PharmD, associate vice president of clinical information, who helps oversee Prime’s clinical publications. “That’s why we believe it’s so important for us at Prime to help health plans and healthcare providers understand the value of the latest treatments, so they can prescribe and cover the most effective, yet affordable, therapies for migraine disorder.” 

Given the unmet need for migraine drugs, there is ongoing research for this condition. Some examples include two first-in-class investigational agents. One biologic in early clinical trials, intravenous bocunebart, targets a different pathway from CGRP medications. It blocks the pituitary adenylate cyclase-activating polypeptide (PACAP) pathway and could potentially offer an option for patients who do not respond adequately to current preventative therapies. Another agent in earlier phases of study is oral elismetrep, which blocks transient receptor potential melastatin 8 (TRPM8), offering a new mechanism for acute migraine treatment. 

Research insights help guide treatment 

Prime also conducts research to evaluate the efficacy and cost-effectiveness of various treatments. A 2022 study by Prime’s health outcomes team evaluated real-world triptan use among 15 million commercially insured members. The study found that half of patients who used triptan medications for migraines didn’t refill their prescription and only 1 in 10 tried more than one type of triptan within a year. The same pattern continued after two years. These low refill and switch rates suggest patients may not be satisfied with triptan therapy. 

“Understanding real-world migraine drug usage patterns can help health care decision-makers decide how to manage newer migraine treatments,” said Pat Gleason, associate vice president, health outcomes. “At Prime, we’re honored to contribute to the understanding of drugs are used in the real world.”  

Making medications accessible and affordable for patients

Finding the right therapy is only one step in the treatment journey. Patients also need their treatments to be affordable. That’s where Prime’s industry-leading HighTouchRx^® program can help. Through a combination of data-driven analytics, pharmacist outreach and personalized intervention strategies, HighTouchRx helps manage the cost of migraine and specialty medications. According to internal data, the product has helped save clients more $1.5 million on migraine drugs. 

“HighTouchRx finds more cost-effective medications, while also helping patients receive appropriate migraine care,” said Marie Wimmer, director of program capabilities. “This enables them to remain focused on their health rather than concerns about whether they are on the best treatment at the best possible cost.” 

Preventive management program helps address adherence, gaps in care

Once patients find the best-fit medication at an affordable price, it’s important to support patients as they embark on their treatment journey. Through optimal medication management, GuidedHealth^® helps Prime’s members make better medication management decisions by improving drug safety and addressing medication adherence, gaps in care, unsafe use and potential misuse. GuidedHealth recently introduced a Migraine Preventive Therapy program for all lines of business that offers preventive interventions in support of the PQA Migraine Preventive Therapy (MPT) measure. 

“Migraine episodes can be highly debilitating, disrupting a patient’s ability to work, function and maintain daily routines,” said Sara Manderfield, director, clinical program capabilities. “By offering a migraine preventive therapy program, GuidedHealth is doing the right thing for the patient — helping reduce the frequency and severity of episodes while supporting better health, stability and quality of life.” 

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Learn more about how Prime helps patients and payers manage migraine