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Why are Migraine Drugs So Expensive?

September 8, 2020

high drug prices

For already hard-hit American consumers, even something as basic and essential as migraine medication can be unaffordable.

Yet, as migraine sufferers know, no price seems too high in the midst of an attack, especially for chronic migraines, which can be debilitating and drastically affect a person's quality of life. That said, a treatment that's too expensive to use is just as bad as not having any treatment at all.

So, what makes migraine drugs so expensive? In addition to systemic factors baked into the U.S. healthcare system and prescription drug market that make most prescription drugs too expensive, migraine drugs also have some unique features and characteristics that push up an already steep price tag.

The Cost of Migraine Treatment in the United States

Migraines are complex — both to treat and live with. As those that suffer from them know, it isn't always as simple as napping them away or just taking a few OTC painkillers. For frequent sufferers, you'll often need medication to prevent them — and medication to take when you can feel one coming on.

Chronic migraine sufferers can experience several episodes in a single month, which can be debilitating and drastically impact quality of life. For Americans, even minor chronic health problems tend to come with a hefty price tag. Migraine medication is expensive, even if you have health insurance with robust prescription drug coverage.

Even compared to other drugs, many migraine medications are notable for just how expensive they are — especially when you compare prices to what people pay just across the border in Canada, and in many other countries.

According to industry data, U.S. spending for neurological disorders — like chronic migraines — is almost $800 billion per year and rising. Of that, migraine expenditures account for almost $80 billion. On an individual basis, migraine treatment can range from $2,000 to over $9,000 per year for episodic and chronic migraine episodes.

As if the cost of migraine drugs weren't bad enough, migraine treatment also includes indirect costs, such as income loss and decreased productivity at work (which may be excacerbated for many Americans don't receive sick pay or family leave) and secondary health issues related to migraines, such as anxiety and depression, among others.

In addition to the social and professional costs of dealing with migraines, as many as two thirds of migraine sufferers in the United States don't take prescription medications due to the cost, or take less than the prescribed dosage in order to ration their prescriptions to reduce costs and make them last longer.

Does Health Insurance Cover Migraine Drugs in the United States?

The short answer is that it depends. In the complicated and confusing American healthcare system, even having health insurance coverage is no guarantee that a prescription medication will be affordable — or even available. Guidelines and competing priorities between the pharmaceutical and insurance companies can actually make it more difficult (and expensive) for Americans to get the drugs prescribed by their doctors, depending on the type of insurance they carry.

Pharmaceutical companies, which already set astronomically high and inflated list prices in the United States for many of their drugs, try to get newer (and often more expensive) prescription drugs into the hands of as many patients as possible. This tactic is especially popular when a pharmaceutical company wants to kneecap competition if a patent is about to expire which will make room in the market for a cheaper alternative.

Insurance companies are also profit driven, so if the cost of a particular medication is deemed too high (as has been the case with many migraine drugs), they will either drop coverage, create onerous eligibility guidelines that patients must meet before the drug will be covered, or try to push people towards a cheaper drug than the one prescribed by their doctor.

This is especially problematic because doctors and patients often have no idea what an individual insurance plan will actually cover, or how much a particular prescription will cost an individual. There are just too many individual variables at play — and that can be frustrating for both patients and doctors.

Every insurance plan has different guidelines for covering prescription drugs for migraines, such as the number of headaches a person has per month, treatment by a neurologist or specialist (which can be difficult or impossible for many Americans due to added costs), and whether or not an older or cheaper medication has already been prescribed.

The stress, hassles, and red tape that many Americans face when dealing with their insurance companies can force many people to suffer without the medications they need in order to avoid additional financial and emotional stress.

Lack of Funding and Research

Unlike other chronic and debilitating illnesses, research for migraine diagnosis and treatment is woefully underfunded which makes it more difficult and expensive to treat. According to the American Journal of Managed Care (AJMC), "migraine" is the third most common disorder and the sixth most debilitating around the world.

In the U.S., approximately one in five working age adults report suffering from migraine headaches at least once in the previous three months. At least four million Americans are believed to suffer from chronic migraine disease, but the numbers are probably higher due to limited research and misdiagnoses.

How Canada Keeps Migraine Drugs and Prescription Medications More Affordable than the United States

To outside observers, the American healthcare system and its associated prescription drug costs are inexplicable. Despite the fact that the United States spends more on health care than any other country in the world, most of which comes from the federal government (specifically American tax dollars), over 20 million people are completely uninsured, and millions more are underinsured, meaning they lack adequate or affordable coverage for their medical needs.

By 2017, the United States was spending $3.5 trillion (roughly 18% of GDP) on health care costs. How's that possible? Lack of regulation and no caps on spending make everything from prescription drugs to health care services exponentially more expensive in the United States than anywhere else in the world.

Everything from a trip to the pharmacy to pick up a prescription for a migraine headache to a visit to the emergency room costs the average American thousands of dollars more than virtually anywhere else in the world.

In other developed countries like Canada, the government spends far less but citizens get more than in the U.S. at the pharmacy counter because the government sets limits on how much pharmaceutical companies can charge for prescription drugs.

The Price of Migraine Drugs in Canada vs. the United States

Americans have other options, though. Through websites like NorthWestPharmacy.com, Americans can safely take advantage of the cheaper drugs offered elsewhere in the world, like Canada. As NorthWestPharmacy.com is a CIPA (Canadian International Pharmacy Association) certified website, our pharmacy partners are held to an exceedingly high standard — meaning that you'll get the appropriate medication safely delivered right to your door cheaper than you would through your local pharmacy chain.

Here's a comparison of how much Americans can save by sourcing their drugs through a Canadian online pharmacy and international drugs website, like NorthWestPharmacy.com:

Cost of Sumatriptan

Sumatriptan (generic Imitrex) is a relatively inexpensive migraine drug compared to other medications, but the retail price in the United States is approximately $94 for 9 pills of the 100mg, which still makes it relatively expensive for the millions of Americans living on a fixed income. American consumers can save almost 50% by buying Imitrex outside of the United States.

Cost of Dihydroergotamine Mesylate

On the other end of the affordability spectrum is dihydroergotamine mesylate, a prescription available by nasal spray or injection used to treat migraine headaches with or without aura. The average retail price for dihydroergotamine mesylate is $3,339.45 for the 3mL nasal spray and $500 for five ampules (for intramuscular injection) in the United States.

Through NorthWestPharmacy.com, the 3mL nasal spray is less than $64 a pack of 5 ampules of injectable dihydroergotamine mesylate costs $93. That means the U.S. price for these two migraine drugs is more than 53 and 5 times the price, respectively!!!

Cost of Topiramate

Topiramate is the generic alternative to Topamax, which is prescribed to prevent migraine headaches. The average retail price for a 60-pill topiramate supply in the U.S. is $51.35. That's relatively cheap (although still expensive for many Americans struggling to afford basic necessities and health care costs) compared to brand name Topamax, which has an average retail price of $1,243.78 for a 60-pill supply.

By comparison, a 60-pill supply of topiramate ranges from $14.89 to $36.97 from NorthWestPharmacy.com. A 60-pill prescription of Topamax ranges from $59.99 to $208.99, depending on the dosage.

Cost of Cafergot

Cafergot is a prescription medication that can be used to prevent and treat migraine and cluster headaches. The average cash retail price for a 20-pill supply of Cafergot in the United States is $378.03. While that might seem "cheap" compared to the outrageous average retail price of some of the other prescription drugs for migraines on this list, consider the fact that according to some reports, as many as 40% of Americans can't afford a $400 emergency.

Through NorthWestPharmacy.com, a 20-pill supply of Cafergot averages $27.09 and a 100-pill supply costs $62.49.

Cost of Relpax

Relpax is a prescription medication to treat (not prevent) migraines once a headache has developed. The average retail price for a six-pill supply of Relpax is $418 in the United States, or roughly $70 per pill.

Through NorthWestPharmacy.com, a six-pill prescription of Relpax costs $72.69, or roughly $12 per pill, meaning that a single pill in the United States costs as much as the entire prescription of the same medication through either a Canadian or an international pharmacy.

This is a particularly stark example of the gross price disparities between the two countries, but it's hardly the only one. For migraine sufferers in the U.S., even supposedly "affordable" prescription drugs can be too expensive. On the higher end of the price spectrum where a single prescription can cost thousands of dollars, it can make treatment impossible.

For people who suffer from chronic migraines, this makes an already difficult problem much worse, given that a single episode can last for days and even up to a week if the migraine includes aura and aftereffects.

To learn more about how you can save money on migraine drugs and other prescription medications by ordering from an online Canadian pharmacy, contact our customer service department today for more information. You can call us directly at our toll free number, 1-866-539-5330, or send us an email to get in touch with a customer service representative who will answer all of your questions and explain the ordering process in detail.

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