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Tackling migraine’s silent toll is a global challenge and a major headache

Sarah starts her day already at a disadvantage. A fog of fatigue settles over her before she’s even had a chance to drink her morning coffee.

It’s a subtle but familiar sign – as a busy project manager and mother of two, Sarah quietly braces herself, knowing she’s going to be navigating a migraine attack for yet another day. Even the hope of relief sometimes feels just out of reach – due to obstacles in accessing effective treatment – adding another layer of frustration to her morning routine.

Throughout the morning, Sarah presses on but faces mounting difficulty in meetings. The office lights seem harsher and a throbbing, pulsing headache occurs on one side of her head. By lunchtime, nausea has set in, but Sarah keeps going, unwilling to let her colleagues down or be seen as unreliable.

By the time she leaves work, her migraine is in full force – searing pain pulses with every sound on her commute. At home, despite being desperate to spend time with her children, the most she can manage is retreating to a dark room, missing dinner and bedtime stories.

Guilt lingers, as does exhaustion. The effects remain long after the pain subsides, aggravated by the ongoing challenge of finding a treatment pathway that truly works for her.

Sarah is fictional. And yet her story is typical of what we hear from women living with migraine. This is the reality for over a billion people worldwide. Migraine is far more disabling than the phrase ‘just a headache’ implies.

Migraine is the second leading cause of disability globally, yet a survey conducted in over 40,000 migraine patients in Europe showed that 93% think that the condition is not well understood by the general public.

Its invisibility fuels stigma, delays diagnosis and limits access to effective care. This is especially the case for women, who are three times more likely to experience migraine than men and often face longer, more intense attacks.

These challenges for women may further be compounded by medical gaslighting, with many women feeling healthcare professionals do not take migraine or them seriously.

Clearly migraine’s ‘silent toll’ on women demands urgent, systemic change. This starts with recognising migraine as a serious, chronic condition that can disrupt women’s family and social life, education and career.

Behind these issues are real women, many of whom are forced to navigate fragmented care pathways, trial-and-error treatments and outdated reimbursement systems that don’t reflect the latest clinical guidance.

In recent years, several medical groups, including the European Headache Federation (EHF) and the American Headache Society (AHS), have supported new innovative therapies as appropriate first-line prevention for migraine.

However, despite the progress in recommendations, the reality is that many patients still face barriers to accessing new, innovative treatments.

A survey conducted in 2021 by the European Migraine and Headache Alliance (EMHA) found that significant recurring barriers for patients include:

• Doctors not mentioning certain treatment options
• Healthcare systems not yet reimbursing particular therapies
• Patients not yet being eligible for certain treatments.

The pharmaceutical industry can play a leading role in helping to create a better future for migraine patients, both from a treatment perspective and more broadly.

We must be steadfast in our commitment to continued investment in migraine research: advancing innovative therapies and deepening our understanding of this complex neurological condition.

At Organon, we and our partners focus heavily on real-world data, providing insights that go beyond clinical trials to reflect how treatments perform in everyday settings.
By analysing outcomes in practice, real-world evidence helps validate the effectiveness and tolerability of migraine therapies for those who especially need them. It also informs clinical decision-making and guides the evolution of care standards, ultimately leading to better, more personalised outcomes.

The type of real-world data we collect is also important. While reducing the number and severity of migraine attacks is important, these metrics don’t fully capture how migraines affect a person’s ability to work, study or enjoy life.

Some patients may have relatively infrequent migraines but experience severe disability when attacks occur, making quality of life (QoL) measures more reflective of their true burden. Incorporating QoL into the data we capture helps ensure that the impact of our therapies reflects patient priorities.

However, in order to enact change in clinical practice, we can’t focus on patients alone. Broader society must be better educated and understanding of the true impact of migraine. The pharmaceutical industry is uniquely positioned to drive this.

By combining education, advocacy, support for healthcare professionals and evidence-based communication, we can help raise awareness of migraine as a serious neurological condition and work towards ensuring that fewer people feel they have to suffer in silence.

We also need to demonstrate the true value of therapies – again, not just to individual patients, but to employers, healthcare systems and the broader community: articulating the economic benefit of migraine therapies through measures such as healthcare resource utilisation and reductions in absenteeism and presenteeism.

Ultimately, these efforts all support better policy and funding decisions, which will be to the benefit of people living with migraine and society.

The time for incremental progress is over. There is an urgent need for recognition of migraine as a serious, disabling condition in need of wide-ranging treatment options, comprehensive policy reforms and commitment to equity.

Too many people struggle in silence, hindered by stigma, inadequate care and systemic barriers preventing timely diagnosis and treatment access.

Real change will require collaboration across the healthcare ecosystem.  Pharmaceutical companies, policymakers, healthcare professionals and patient advocates must work together to drive innovation, improve education and ensure that effective, personalised treatments are available to all who need them.

If we do not act, women and economically disadvantaged groups may continue to be disproportionately affected.

Through partnership and advocacy, we have the opportunity to make a meaningful difference in migraine care and potentially positively impact the lives of over a billion people worldwide.

Ger Brennan is Global Commercial Lead at General Medicines at Organon