3 ObjectiveThe overall objective of this research is to explore the unmet migraine treatment needs of migraine sufferers.Additional objectives of this research are to:Understand patient perceptions and attitudes toward current treatment methodsDetermine key attributes associated with effective treatmentsIdentify expectations of treatment and where current treatments are falling short3
4 Research Methodology National custom telephone survey Among medically diagnosed migraine patients years of ageTotal n = 500 with an overall margin of error of ± 4.5%, in 95 out of 100 cases.Computer-assisted telephone interviewing.Data collected March 19- March 27, 2010WhoHow ManyHowWhenWhat4
6 Executive SummarySufferers lack a standardized, effective treatment option for combating serious symptoms and side effects of migraines.The most common type of migraine attack, that affects 69% of sufferers, is the rapid onset migraine (it just sneaks up on you) with or without nausea and vomiting.And, over half (53%) of sufferers experience a migraine on a monthly basis.And yet, three- fourths of sufferers (74%) admit they do not record their migraine attacks.When it comes to treatment options, over-the-counter medications (72%), lifestyle management (72%), and prescription migraine treatments (57%) top sufferers most common lines of defense.Only half of migraine sufferers agree, when I get a migraine with nausea or vomiting, after taking my migraine medication, I typically get fast relief that allows me to get back to my work/life.And only 38% of sufferers strongly agree I am satisfied with how quickly my current medication works.6
7 Executive SummarySufferers are talking to their doctors about the best treatment options available for their migraine episodes.Over half of oral medication users (55%) talk to their doctor about their migraine attacks once every 6-12 months.Most often sufferers admit they discuss ways to manage my migraine attacks (79%) and possible lifestyle changes (79%).In these conversations, 62% of oral medication users said they mentioned that prescription oral tablets don’t always work for all their migraine attacks.Users of oral prescriptions want an effective option to take during a migraine to help combat their serious symptoms.Over half (54%) of migraine sufferers use oral prescription medications to manage their migraines.Of those not taking prescriptions, cost (18%) and experienced side effects (14%) are the main reasons why many sufferers are not taking prescription medication to manage their migraines.Among oral medication users, half (54%) admit they have experienced migraine attacks where they didn’t think prescription oral tablets would be an effective treatment option.When prescription oral tablets aren’t an effective treatment option, one-quarter (23%) of sufferers admit they just have to wait it out and endure the headache.7
8 Executive SummaryWhile sufferers are satisfied with their current treatment options, there is an opportunity to better meet sufferers overall needs.The majority of prescription medication users (87%) are satisfied with their current prescription medication.And yet, 31% of sufferers admit their doctor has prescribed more than one medication at a time to manage their migraines.Prescription medication users look to migraine medications to offer the quickest relief possible regardless of the form (41%), the ability to use the medication and continue with regular activities (38%), and for the medication to be lower in cost and covered by insurance (38%).8
11 Frequency of Migraines Over half of migraine sufferers admit to having a migraine at least once a month.How often do you suffer from migraines?52% suffer at leastonce per monthQ1. How often do you suffer from migraines? Would you say…?11
12 Type of MigraineRapid onset migraines and migraines with nausea and/or vomiting occur most often among sufferers.Other migraine occurrenceMigraine upon waking in the morning49%26%Rapid onset migraineMigraine with nausea and/or vomiting69%66%Q2. Do your migraines occur in any or all of the following ways?12
13 Migraine SymptomsAnd, over four in ten sufferers, report rapid onset migraines occur most frequently.Which do experience most frequently?Q3. Of these migraine attacks, which do you experience most frequently?13
14 Tracking Your Migraines And yet, only the minority of sufferers track their migraine attacks.Q4. If you record your migraine attacks, what tools do you use?14
15 Treatment Options Available Sufferers are aware of a wide variety of treatment options including prescription pills, OTC medications, and lifestyle management changes.Q5. Which of the following migraine treatment options are you aware of?XX% reported none of the above15
16 Options For TreatmentAnd yet, the majority of sufferers admit they turn to over-the-counter medications to treat their migraine attacks.N=500Total %I take over-the-counter medications to treat my migraine attacks62I take prescription medication when I feel a migraine coming on or begin experiencing migraine attacks42I take prescription medication, but wait to use it until I am sure it is really a migraine36I have stopped taking prescription/OTC medication to treat my migraine attacks21I take a daily prescription medication to prevent migraine attacks16I have never taken prescription medication to treat my migraine attacks416Q6. Which, if any, of the following best describes your current migraine treatment options?
17 Current Treatments Being Used Regularly sufferers try over-the-counter medications, lifestyle management, and prescription oral pills or tablets to manage their migraines.As suffers age, they are more likely to use lifestyle management as a way to manage their migraines; ages (56%), ages (72%), ages (76%), and ages (73%).N=500Total %Over-the-counter medications72Lifestyle management (e.g. diet, sleep, exercise, stress reduction)Prescription oral pills or tablets54Alternative remedies including acupuncture, herbs, and chiropractic/osteopathic manipulation30Prescription injection8Prescription nasal spray7Prescription needle-free injection3Something else52% reported none of the above17Q7. Which, if any, of the following best describes the current treatment options you use to manage your migraine?
18 Prescription Medications Of those taking prescription medications, Imitrex tablets are most often prescribed.69% of Sufferers take Oral Meds56% admit to taking other forms (nasal sprays, injections, etc…) of Rx medsUsers of Rx MedsTotal %N=284Imitrex Tablets42AXERT4Maxalt18AmergeImitrex STATdose13Zomig Nasal Spray3Treximet12ErgotaminesRelpax11Frova2Imitrex nasal spray10SUMAVEL1Zomig Tablets9Something else406% reported none of the above18Q8. Which if any of the following prescription medications do you take for migraines?
19 Other Medications for Migraines Other medications migraine sufferers are taking include: Topamax, butalbital/acetaminophen, and prescription and regular strength over-the-counter medications.Word Cloud of Other responsesQ9. If you are not taking prescription medications to manage your migraine, please explain why? (Other Coded Responses)19
20 Barriers To Prescription Medications Barriers to prescription medications most often include cost and side effects.Why do you not use prescription medications to manage your migraine attacks?Midwesterners are significantly more concerned with cost than in other areas; Midwest (26%), Northeast (5%), South (19%), and West (10%).N= Those not taking a prescription medicationQ9. If you are not taking prescription medications to manage your migraine, please explain why?20
21 Barriers To Prescription Medications And often times OTC medications works well enough or sufferers just don’t see a need for taking prescription medications.Word Cloud of Other responsesQ9. If you are not taking prescription medications to manage your migraine, please explain why? (Other Coded Responses)21
23 Satisfaction with Current Medication Nearly nine in ten sufferers admit they are satisfied with their current prescription medications.87%Very or Somewhat SatisfiedOral prescription medication users are more satisfied with their current medication than users of other prescription medications (89% vs. 62%).N= 284Those who use prescription medicationQ10. Overall, how satisfied are you with your current prescription medication(s)? Are you…?23
24 Satisfaction with Speed of Treatment While three-fourths of suffers admit they are satisfied with how quickly their medication works, suffers are less satisfied with how quickly they can be back to work/life after taking migraine medications for migraines upon waking .% AgreeQ10. Overall, how satisfied are you with your current prescription medication(s)? Are you…?24
25 Important Attributes in a Medication When it comes to relief, those who take prescription oral medications want a medication that is inexpensive/covered by insurance and offers quick relief, while not disrupting their day.N= 271 Those who take a n oral prescription medicationMost ImportantThe quickest relief possible regardless of form (i.e. pill, nasal, injection, etc…)41Able to use medication and continue with regular activities38Lower cost, covered by insuranceIs effective at any stage of the migraine32Easy to use29Few side effects24I can use it effectively even when nauseated or vomiting19Long-lasting effect17No needle required to administer16Other32% reported none of the above/not sureQ11. What is the most important attribute of a prescription migraine medication?25
26 Current Attributes in Treatment Options And yet, nearly half of prescription users don’t feel their medication provides the quickest relief possible at a low cost.N= 271 Those who take a n oral prescription medicationCurrent AttributesEasy to use85No needle required to administer67Few side effects65Able to use medication and continue with regular activitiesThe quickest relief possible regardless of form (i.e. pill, nasal, injection, etc…)56Lower cost, covered by insuranceLong-lasting effectI can use it effectively even when nauseated or vomitingIs effective at any stage of the migraine53Other23% reported none of the above/not sureQ Does your current treatment offer the following attributes?26
27 Satisfaction With Imitrex STATdose Overall, sufferers who are prescribed Imitrex STATdose are satisfied with the way the treatment relives their pain.84%Very or Somewhat SatisfiedN= 32 Those who use STATdose *Caution Small Base SizeQ13. if you have ever been prescribed Imitrex STATdose (sumatriptan injection) to manage your migraine, how satisfied were you with how well it relieved your migraine?27
28 Satisfaction With Ease of Use And sufferers are satisfied with how easy it is to use STATdose.91%Very or Somewhat SatisfiedN= 32 Those who use STATdose *Caution Small Base SizeQ14. How satisfied were you with how easy it was to use Imitrex STATdose (sumatriptan injection)?28
29 Reasons for Not Trying STATdose The majority of those not taking STATdose are not opposed to the medication or its side effects, but rather were unaware of this type of medication or the doctor recommend another treatment.2% reported not sureN= 355 Those not taking STATdoseQ15. Which of the following statements best describes why you have not used Imitrex STATdose (sumatriptan injection)?29
31 The Need For Alternative Options Pills aren’t always an effective treatment option for the majority of migraine sufferers.Yes54%No44%N= 271Those who take an oral prescription medicationQ20. If you use oral prescription migraine medications, have you ever experienced migraine attacks where you didn’t think prescription oral tablets would be an effective treatment option?31
32 Managing MigrainesAnd less than two in ten sufferers feel they have other prescribed medications when oral pills are not an option.When oral pills are not an option, how do you mange your migraine attacks?N= 271 Those who take prescription oral medicationQ21. When prescription oral tablets aren’t an effective treatment option given the nature of your migraine attack, how do you manage your migraine?32
33 Sickness from Medications… Nausea and vomiting prohibits one-third of sufferers from taking their prescription medications.Yes37%No63%N= 271Those who take prescription oral medicationQ22. Have you ever delayed or avoided taking your medication due to nausea or vomiting resulting from the migraine?33
34 Getting Back to Life…Nearly half of sufferers admit, they don’t get fast relief after taking their medication to relieve a migraine with nausea or vomiting.46%DisagreeWhen I get a migraine with nausea or vomiting, after taking my migraine medication, I typically get fast relief that allows me to get back to my work/lifestyle54%AgreeN= 500Q19. Please tell me how much you agree or disagree with each of the following34
35 Discussing with Your Doctor… And two-thirds of sufferers admit they are talking to their doctors about this problem.Yes62%No36%N= 271Those who take prescription oral medicationQ24. have you mentioned to your doctor that prescription oral tablets don’t always work for all your migraine attacks, such as those that include nauseas or vomiting?35
37 Working With Your Doctor to Relieve Symptoms The majority of sufferers discuss lifestyle changes and ways to manage their migraine attacks with their doctors.79%AgreeMy doctor and I discuss lifestyle changes that could help prevent migraines from occurring79%AgreeMy doctor and I discuss ways to manage my migraine attacksN=500Q19. Please tell me how much you agree or disagree with each of the following?37
38 Seeking Migraine Knowledge And, over half of sufferers are talking to their doctor twice a year or more about their migraine attacks.1% reported not sureN= 271Those who take prescription oral medicationQ23. How often, if ever, do you talk to your doctor about your migraine attacks?38
39 One Problem, Multiple Medications… Less than three in ten sufferers agree my doctor told me I need more than one medication or treatment option to effectively manage my varying migraine occurrences.26%AgreeMy doctor told me that I need more than one medication or treatment option to effectively manage my varying migraine occurrences.N=500Q19. Please tell me how much you agree or disagree with each of the following?3925.
40 One Problem, Multiple Medications… Yet, nearly one-third of patients have been prescribed multiple medications for their migraine symptoms.Yes31%No69%N=500Q16. Has your doctor ever prescribed more than one medication at a time (e.g. oral tablet and injection or nasal spray, etc…) to mange your migraine?40
41 Reasons for Multiple Medications Nearly one-third of sufferers admit I take one kind of medicine daily and a different one at the time of a migraine attack.16% reported not sureN= 154 Those taking more than one medicationQ17. What was the primary reason for the doctor prescribing more than one medication at a time?41
42 Seeking Migraine Knowledge Most often multiple medications are requested because the medicine didn’t relieve the migraine symptoms.25%Didn’t relieve mymigraine17%Didn’t work for certain migraine attacksDidn’t work fast enoughCaused side effects8%9%Change/update colors37%Didn’t ask the doctor for an alternative treatmentN= 271Those who take an oral prescription medicationQ25. Which of the following is – or would be- the primary reason for asking your doctor about prescribing an alternative or additional treatment to oral tablets?42
43 Word Cloud of Other responses Improving TreatmentWhen it comes to improving the current treatment methods, sufferers want medication that works better, and overall is more affordable.Word Cloud of Other responsesQ18. In your opinion, what if anything, can be done to improve your current treatment?43
45 Demographics Gender Female: 88% Male: 12% Income Under $25K: 12% $25K to 49,999: 22%$50K to 74,999: 24%$75K to 99,999: 16%100K or more: 15%Age18-24: 0%25-30: 8%31-35: 33%36-40: 27%41-45: 32%45+: 0%EmploymentEmployed: 69%Unemployed: 31%RegionMidwest: 39%South: 33%Northeast: 17%West: 10%Race/EthnicityWhite: 92%Black: 2%Hispanic: 2%Other: %45
46 Attitudinal Statements Total %N=500Agree(Strongly + Somewhat)Strongly AgreeSomewhat AgreeMy doctor and I discuss lifestyle changes that could help prevent migraines from occurring795622My doctor and I discuss ways to manage my migraine attacks5425I am satisfied with how quickly my migraine medication works743836When my migraine comes on suddenly, after taking my migraine medication I typically get fast relief that allows me to get back to my work/life6439When I awaken in the morning with a migraine, after taking my migraine medication I typically get fast relief that allows me to get back to my work/life592633When I get a migraine with nausea or vomiting, after taking my migraine medication, I typically get fast relief that allows me to get back to my work/life1935My doctor told me that I need more than one medication or treatment option to effectively manage my varying migraine occurrences (e.g. upon waking in the morning, with nausea/vomiting, rapid onset, etc…)13Make as header statements/start of sections46Q19. Please tell me how much you agree or disagree with each of the following?