Migraine Australia says changes made today that allow GPs will be able to start their patients on the new migraine management medications on the PBS is a win for rural patients.
The new medications, generally referred to as CGRPs or CGRP antagonists, are the first ever medications designed to prevent migraine attack, and have been fundamentally transformative to the lives of people who live with significant migraine. Introduced for the first time in 2018, they are now considered first line treatment for migraine. Three medications – Ajovy, Emgality, and Vyepti – are currently available for those who meet a range of criteria on the PBS, saving those patients thousands of dollars a year.
However, prior to today, only a neurologist could start a patient on these new medications. This meant that for many, even if you met all the other criteria, you could not try these new treatments if you could not get an appointment to see a neurologist.
As of midnight last night, the condition on the PBS listing was changed from ‘Must be treated by a neurologist’ to ‘Must be treated by a neurologist’ OR ‘Must be treated by a general practitioner in consultation with a neurologist’.
There are around half a million Australians who meet the restrictions and would benefit from these medications, but only 422 registered neurologists in the country.
A spokesperson for Migraine Australia said the rule change is a win for common sense, and a real relief for many.
“This is a really significant win for our community, and one we have fought hard for over the last five years.
“It is particularly good news for rural patients, many of whom were being actively denied medication that could help them solely because they couldn’t access a neurologist.”
The change now means that, in consultation with a neurologist, a GP anywhere in the country can start a migraine patient on the new treatments, without that patient needing to wait sometimes years to get into a neurologist. These are still relatively new medications, and restrictions remain in place, such as needing to be significantly affected by migraine and have failed older medications.
Migraine Australia warns, however, that they aren’t headache medications or pain killers – because migraine isn’t a headache. They only work for people diagnosed with migraine.
Migraine is a complex genetic neurological disorder that has a wide spectrum of presentations. Symptoms of migraine attacks are diverse, ranging from nausea, dizziness, and fatigue, through to stroke-like hemiplegia and significant gastrointestinal upset, as well as the common throbbing headache. Part of the rapid advance in the science that led to these medications is that migraine was redefined as a sensory processing disorder.
The organisation is strongly encouraging both doctors and other health professionals like pharmacists to take advantage of the various continuing professional development courses offered by professional bodies to get across the very significant changes in the understanding of migraine.
General Practitioners can prescribe any of these medications privately, without the restrictions or need to consult a neurologist, but the cost is prohibitively expensive for most.
Migraine Australia will host a live ‘ask us anything’ session for people living with migraine in the Migraine Australia Chat Group on Facebook at 7.30pm AEST tonight, and information about these new treatments is available from the Migraine Australia website here.
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