Migraine: Medical Treatments
The question
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of regional variation in access to CGRP and gepant migraine treatments for patients; and what steps he is taking to ensure that adult neurology waiting lists do not delay access to clinically appropriate alternative treatments.
Answered by Mrs Sharon Hodgson
The Department recognises concerns about variation in access to specialist headache services, which can affect the prescribing of newer therapies typically initiated in secondary care.
The National Institute for Health and Care Excellence (NICE) has published technology appraisals recommending a number of calcitonin gene-related peptide (CGRP) treatments and, more recently, gepants for specific groups of patients, and these should be made available in line with those recommendations. It is the responsibility of integrated care boards to commission services and ensure appropriate access to NICE-approved treatments for their local populations.
General practitioners can prescribe some gepants, such as rimegepant and atogepant, for migraine prevention, provided it is done in accordance with local shared-care agreements or after an initial specialist recommendation.
NHS England is taking steps to reduce variation and improve access through neurology networks, and programmes such as Getting It Right First Time, which support more consistent pathways and earlier use of appropriate treatments where clinically indicated.
We are also aware of the impact that waiting times for neurology services can have on access to specialist-prescribed treatments. NHS England is working to improve elective recovery, including for neurology, and to support pathway redesign so that patients can access the most appropriate treatment without unnecessary delay.
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