Biohaven survey uncovers patient-doctor communication gaps for migraines and mental health

Patients and doctors agree that worsening migraines can impact mental health and vice versa. And while talking with a doctor about both can help, those conversations aren’t happening as much as they could be.

That’s according to a new survey on migraines and mental health by the American Migraine Foundation and Biohaven Pharmaceuticals, maker of migraine drug Nurtec ODT. The online survey, conducted between April and May 2022, polled 1,100 people who had both migraine and a mental health condition as well as 302 HCPs who treat neurological diseases including neurologists, headache specialists and general practitioners.

Although two-thirds of patients said it was important to discuss mental health with the HCP treating their migraine, more than three-quarters (77%) said they worried about stigma and were hesitant to broach the topics. 

And while nearly all patients believe it is equally important to treat their migraines and mental health and want their doctor to prioritize both, a third of HCPs sensed that their patients want them to focus only on their headaches. 

The survey also uncovered a gulf between how often doctors said they were initiating those conversations and what patients said they actually experienced. While 70% of HCPs surveyed said they ask their patients about mental health conditions often, nearly 60% of patients said they were the ones who started the discussion. 

“Closing the gaps in communication between healthcare professionals and their patients can help improve migraine and mental health management,” Larry Newman, M.D., a neurology professor at New York University and chair of the migraine foundation, said in a press release. “These are important conversations that both people with migraine and healthcare professionals should initiate at every visit.”

When it comes to recognizing the link between mental health and migraine, however, doctors and patients were on the same page. More than 90% of HCPs and 84% of patients agreed worsening migraine leads to poorer mental health; likewise, 87% of patients and 94% of HCPs believe mental health would benefit from better migraine control.

But the survey found doctors underestimate the percentage of migraine patients who are depressed or anxious. While at least half of patients surveyed reported being diagnosed with either an anxiety disorder (57%) or depressive disorder (50%), doctors estimated those conditions occur in just 29% and 30% of migraine patients, respectively. 

Biohaven sponsored the study because it wanted to learn more about the connection between migraines and mental health from both the patient and HCP perspective, and because mental health is a priority for the migraine advocacy community, Lauren Murphy, Biohaven’s director of consumer marketing, said in an email.

“The more we can do to illuminate the connection between mental health and migraine will help us to better understand the journey of people with migraine and drive the productive conversations between doctors and patients that lead to better migraine management and improved outcomes,” she said.

Biohaven’s Nurtec is one of several new CGRP drugs that have come on the market in recent years in the fiercely competitive migraine space. Others include AbbVie’s acute migraine med Ubrelvy and preventive treatment Qulipta, Eli Lilly’s Emgality, Amgen’s Aimovig and Teva’s Ajovy. 

The company is preparing to turn over its migraine franchise to pharma giant Pfizer in a $11.6 billion deal expected to close by early 2023.