Neurologists recommend two types of drugs when a moderate-to-severe migraine strikes: "triptans" (such as sumatriptan) or dihydroergotamine (DHE). For the majority of migraine sufferers whose headaches are frequent or severe, neurologists also recommend a daily dose of one of several preventive medications.
The researchers used these recommendations from the American Academy of Neurology to define standard migraine treatment and found that the uninsured were nearly twice as likely as the privately insured to receive substandard treatment.
Medicaid enrollees were 50 percent more likely to receive substandard treatment, suggesting that "access to some forms insurance is not the same as access to adequate care," the researchers wrote.
Care in doctors' offices was substantially better than in emergency departments. The fact that the uninsured are less likely to get care in doctors' offices explained some, though not all, of their substandard care.
Most people with migraine are impaired by their headaches and the accompanying nausea, and lose an average of four to six days of work annually.
Dr. Steffie Woolhandler, professor of medicine at Harvard and study co-author, said: "Lack of insurance clearly takes a heavy toll on our patients and the economy. Regrettably, the health bill just signed into law will leave tens of millions of Americans uninsured or poorly insured and thus unable to get the care they need."
Dr. Andrew Wilper, lead author of the study, said: "We showed that the uninsured have a higher risk of death when compared to those with insurance. Lack of insurance also puts patients with migraine at risk for needless suffering due to lack of access to standard medical therapy."
|Contact: Mark Almberg|
Physicians for a National Health Program