Understanding Patients’ Journeys Prior to Initiating Calcitonin Gene-related Peptide Monoclonal Antibody for Migraine Prevention in the United States
Maurice Vincent1, Margaret Hoyt1, William R. Lenderking2, Lucinda Hetherington2, Dustin Ruff1, Gilwan Kim1, Lars Viktrup1
1Eli Lilly and Company, 2Evidera
Objective:
To describe experience with migraine and factors influencing the decision to seek treatment in a cohort of patients in the US initiating galcanezumab for migraine prevention.
Background:
Although migraine is associated with several disabling symptoms, many patients are reluctant to initiate pharmacological treatment. Understanding the path in seeking care may highlight opportunities for intervention.
Design/Methods:
We conducted a cross-sectional, self-reported, online survey among 500 patients enrolled in the galcanezumab Patient Support Program between Jul-Dec 2022. Patients were ≥18 years of age, diagnosed with episodic (n=250) or chronic (n=250) migraine, and prescribed galcanezumab ≤6 months prior to survey completion. Individual questions and validated questionnaires were used to collect insights on patients’ experience with migraine and interaction with healthcare professionals (HCPs) prior to initiating galcanezumab. All analyses were descriptive.
Results:
Average time since first migraine symptom was 18.1 years and on average patients visited four HCPs before receiving a migraine diagnosis. Prior to diagnosis, about a third of patients were reluctant to seek professional help for migraine due to a previous unhelpful experience (32.1%)/due to thinking that a physician could not do anything more for their migraine (32.1%)/that a physician would not take them seriously (32.1%). Few patients (18.3%) believed that migraine attacks were due to factors such as stress/diet they could control. Most patients decided to seek professional help for migraine due to increasing frequency (81.0%)/intensity (71.7%) of migraine attacks. Patients reported that the most common explanation the HCP provided for causes of migraine was stress/anxiety/depression (41.6%). Over a third (36.0%) indicated that their HCPs’ explanation that migraine has no cause was aligned with what they had previously thought.
Conclusions:
Patients’ decisions regarding migraine prevention are influenced by past experiences involving triggers and interactions with HCPs. Increased awareness of patients’ journey to treatment may help address misinformation and improve migraine care.