Why is this neurologist rant on TipsForWomens about an anti-migraine treatment?

Why is this neurologist rant on Doctissimo about an anti-migraine treatment?

To relieve migraine patients, there is a new class of drugs: monoclonal antibodies, called anti-CGRP. Effective, they could allow certain patients to avoid suffering from severe attacks but they are very expensive and are not currently reimbursed by Social Security. TipsForWomens interviewed Dr Wilfrid Casseron, neurologist in Aix-en-Provence, who denounces an injustice.

The third French-speaking migraine summit was held on September 9. This 100% digital event, organized and broadcast by La Voix des migraineurs, a patients’ association, was an opportunity for sufferers to let out a cry of anger.

The reason: the lack of reimbursement in Europe for anti-CGRP, monoclonal antibodies which effectively relieve certain patients, severely affected by frequent migraine attacks.

Who are the patients affected by this type of innovative treatment?

When questioned, Dr. Casseron explains to us that there are many migraine patients, but those eligible for this type of treatment are fewer. “To be eligible for monoclonal antibodies, you must suffer from eight days of migraine per month and have avoided at least two basic treatments. This represents between approximately 60,000 and 100,000 patients in Europe, out of the 10 million people suffering from migraines. estimates the specialist.

The prescription must also be made by a neurologist. “This seems to be sufficiently well regulated, in my opinion, however, the health authorities still refuse to reimburse this treatment“.

Authorities who do not recognize “improvement in the medical benefit rendered”

The health authorities, in particular the Transparency Commission, must study the brand new treatment to authorize reimbursement.

The opinions (of this commission) for the 4 anti-CGRP currently existing (Aimovig, Ajovy, Emgality and Vyepti) all include a significant SMR (actual benefit) which means that the importance of their usefulness in the treatment of migraines is recognized. These opinions thus confirm that there is an unmet need for a certain category of patients. notes the patients association La Voix des migraineurs, in its press release.

However, the 4 products obtained an AMSR (improvement in service provided) of V (5) due to lack of comparative study. The one carried out for Aimovig was not recognized as convincing”.

For Dr. Casseron, this makes no sense. “The total cost of this reimbursement should be calculated and compared with the current situation. Estimate the loss of productivity, the number of days of sick leave, the ineffective treatments prescribed for these 100,000 patients and compare them to what the implementation of reimbursement would cost, at only 30% from Security. social, supplemented by mutual societies and health insurance” adds our expert. “This is the only way to realize the effective benefit of this treatment.”

How are these medications delivered at present?

Currently, taking this medication depends on the patient’s wallet. “Among my patients, there are patients who can afford this medication, which costs between 240 and 270 euros per month. It is an injectable pen, like insulin. I prescribe it to them, they take their treatment independently at home and everything goes well” explains the doctor.

But there are also patients for whom it is impossible to pay such a sum every month and who only have to grit their teeth in the face of pain and that is completely unfair.” he denounces again.

For some of these patients, treatment may be prescribed and administered in hospital, for coverage by Health Insurance. “It’s a roundabout way of not making them pay, but it’s not a viable solution. The delays for this type of care vary between six and nine months and given the number of patients, this is untenable. In addition, it must be repeated over time, it is expensive and it takes up places in day hospitalization, which could be used for other patients. Social Security therefore pays for half a day of hospitalization in a day hospital, for treatment which will last ten minutes. With the 500 euros spent, we could treat two patients” he quips.

Will this cry from the heart of patients make things happen? Dr. Casseron hopes so for several reasons: “It is not normal to create two-tier medicine and a selection of access to treatments through money. In addition, Europe is one of the last countries not to have implemented reimbursement for these treatments: Spain, Switzerland and Central Europe have done so..

And he plans for the longer term: “I am also thinking of other diseases, for which similar treatments may be developed in the future. Will they be covered for patients affected by Parkinson’s or Alzheimer’s disease, who are much more numerous?