More than 37 million men, women, and children in the U.S. suffer from migraines, according to the American Migraine Association. Yet, a recent study of more than 13,000 patients diagnosed with migraines reveals that 1 in 3 who have used a prescription medication ends up abandoning it. In recognition of Migraine and Headache Awareness Month, we’re taking a closer look at the medication adherence barriers those patients face—and how an end-to-end patient engagement platform helps eliminate them.
Why Do Medication Adherence Barriers Matter More Than Ever in Migraine Care?
The past decade has brought real innovation in migraine treatment, such as calcitonin gene-related peptide (CGRP) inhibitors. Despite the American Headache Society’s 2024 position statement recommending these breakthrough treatments as first-line therapy, adoption remains frustratingly low. The organization estimates that 40% of patients with migraine could benefit from preventive therapy, yet only a minority of patients are using such treatments.
What Medication Adherence Barriers Put Positive Outcomes at Risk?
Prior Authorization Pain
Prior authorization (PA) delays are one of the most common—and preventable—reasons patients abandon treatment. A 2024 AMA survey revealed that 93% of healthcare providers say PAs “sometimes, often, or always” delay access to care.
For migraine patients, this translates to long waits for approvals on promising specialty medications. PA requirements, for example, may expect patients to “step through” older therapies first—even if those were ineffective or poorly tolerated.
Meanwhile, the attacks continue. Up to 90% of migraine sufferers report being unable to work or carry out daily tasks during an episode. Every delay in access takes a toll on patient productivity, independence, and mental health.
The Cost Conundrum
Cost is another significant medication adherence barrier. When medication costs exceed $100, patients are 62% less likely to be fully adherent to their prescriptions. Migraine medications, particularly newer CGRP inhibitors, often fall into the higher copay category. Such costs are often out of reach for patients juggling lost income from missed work and repeated medical visits.
And it’s not just a personal financial issue. Past analysis suggests that this common neurological condition costs the U.S. economy $36 billion annually in direct healthcare and lost productivity.
Barriers to Medication Adherence Derail Treatment From the Start
The window between prescribing a treatment and the patient’s first fill is a fragile, often overlooked moment. It’s also when many patients quietly abandon their treatment plan—before it ever begins.
One major reason? Uncertainty. Patients often don’t know:
- Whether the medication will be approved
- What the out-of-pocket cost will be
- What patient support programs may be available
By the time a PA receives approval, the moment to act may have passed. Some patients turn to over-the-counter options that don’t offer the same relief as the prescribed therapy. Others do nothing at all. That’s especially concerning for people with migraines.
- 1 in 3 migraine sufferers experience 4 or more episodes a month, making delays in access a serious barrier to relief.
Every day matters.
Once a patient walks away from treatment, it’s hard to get them back. In one study, more than 80% of patients who stopped using acute migraine medications hadn’t returned to a provider for headache care within a year. This creates a ripple effect:
- Patients who need specialized treatment go without it
- Providers lose the opportunity to intervene
- Long-term outcomes suffer, especially for people with chronic conditions
The industry talks a lot about improving awareness, access, and adherence. But those improvements don’t start at the pharmacy counter. They begin the moment a prescription is written—and the system needs to keep pace.
What Can Be Done to Eliminate Medication Adherence Barriers?
1. Reduce Delays and Confusion Around the Prior Authorization Process
Arriving at the pharmacy only to discover that a PA is needed is a momentum-buster for patients. Every extra step—from back-and-forth faxes to surprise denials—only adds to their frustration and threatens adherence.
Well-timed messages—like an alert in the prescriber workflow that a specific diagnosis code will fast-track a PA or an SMS text keeping the patient updated on a PA status—can reduce the risk of abandonment.
2. Address Cost Barriers Up Front
Copay assistance programs work—when patients know about them. Too often, people are unaware they qualify for financial help. That moment—when they’re hit by a high out-of-pocket cost and decide to abandon their prescription—is a critical one. And it’s preventable.
Such a blind spot is more than a missed opportunity. It’s a breakdown in your access strategy—because a patient support program that isn’t visible at the right time might as well not exist.
The key to ending cost-related non-adherence is making affordability information—and copay resources—visible and actionable moments after the prescription is sent. Personalized SMS text messages sent on behalf of a trusted provider can put affordability options at a patient’s fingertips.
Improved Access and Medication Adherence Ends the Needless Toll of Migraines
Untreated or under-treated migraines create far-reaching consequences. For more than 90% of people living with migraines, the challenge goes far beyond physical symptoms, according to the American Migraine Association. It’s a daily disruption—missed classes or meetings, canceled plans, and everyday moments lost—creating a ripple effect that only grows over time. A systematic review of research on the impact of migraines reveals that:
- 71% of patients with chronic migraines felt they would be better parents without migraines.
- On average, 53% of patients with episodic or chronic migraines reported missing out on family activities at least once a month due to their condition.
- 32% expressed concerns about long-term financial stability because of their condition.
Improving time to first-fill and reducing prescription abandonment does more than control the medical aspects of migraine; it preserves the fundamental quality of life that makes patients’ personal and professional relationships meaningful and sustainable.
Ready to Break Through Medication Adherence Barriers?
Medication adherence in migraine care isn’t just a patient issue—it’s a systemic one. It demands better coordination between clinicians, payers, pharma, and tech partners. As we spotlight this challenge during Migraine and Headache Awareness Month, we must also spotlight the solution: removing friction from the first-fill process.
Because developing a breakthrough treatment doesn’t matter if it never reaches the patient.
Want to see how strategic outreach helps patients start and stay on treatment? Check out this success story.
