Conflict of Interest: The author reports no conflict of interest.
Letter to the Editor
Roadblock to the Only FDA-Approved Treatment for Chronic Migraine
Article first published online: 8 JAN 2014
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 54, Issue 1, pages 169–170, January 2014
How to Cite
Charles, J. A. (2014), Roadblock to the Only FDA-Approved Treatment for Chronic Migraine. Headache: The Journal of Head and Face Pain, 54: 169–170. doi: 10.1111/head.12236
- Issue published online: 8 JAN 2014
- Article first published online: 8 JAN 2014
OnabotulinumtoxinA (Botox) is the only drug that is FDA approved for the treatment of chronic migraine (CM). Virtually every insurance carrier in the United States1-4 has adopted a misguided policy of requiring 2 or 3 trials of drugs that are not FDA approved for the treatment of CM before authorizing the use of Botox for CM. The American Headache Society must address these illegitimate and contrived insurance policies blocking the medically indicated use for Botox with the following statements:
- Botox is the only drug FDA approved for CM.
- Botox has virtually no systemic adverse effects.
- This insurance policy has no scientific foundation. These patients are disabled with 15 or more headache days per month. It is medically harmful to patients for an insurance carrier to require 2 or 3 systemic drug trials of drugs that are not FDA approved for chronic migraine before authorizing use of Botox. Patients are exposed to potential systemic side effects to drugs that are not FDA approved for CM. Delaying the use of Botox with unproven, non-FDA-approved therapies only increases the risk of refractory chronification of CM.
- Botox should be utilized for the treatment of CM without first requiring treatment with non-FDA-approved drug treatments.