Why health insurance does not reimburse new treatments

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    Available for a year, some new treatments against migraine are not reimbursed by health insurance – while their effectiveness is well established. Why ?

    Several new treatments for migraine have been available for a year, but they are still not reimbursed by health insurance, as reported by Que-Choisir magazine. In question ? The assessment of health authorities, which limits the prices that can be charged by manufacturers.

    Promising new anti-migraine drugs

    Erenumab, galcanezumab, fremanezumab… These new drugs could relieve patients suffering from chronic and severe migraines. Small bonus: they do not present any cardiovascular risks (heart attack, stroke, coronary heart disease, etc.).

    However, the prescription of these drugs is very supervised. Only patients who have already tested two preventive treatments – without success – can use them. The prescription is restricted to doctors specializing in migraine.

    Restrictions that pose a problem for patients because these new antimigraine drugs have, according to health authorities, real potential.

    No studies have compared their effectiveness

    The lack of hindsight on these new drugs is a first blocking point. Indeed, no study has compared their efficacy with topiramate (Epitomax) or beta-blockers (metoprolol/Lopressor, propranolol/Avlocardyl).

    The High Authority for Health (HAS) has therefore decided to block reimbursement. According to her, current knowledge does not make it possible to ensure that these new injectable drugs are more effective than the others.

    Another blocking point: the price of drugs. This is set by the Economic Committee for Health Products (CEPS) according to a simple rule: the price set by the manufacturer cannot be higher than the cheapest reference treatment.

    In this situation, it is topiramate, which is marketed for around ten euros per box.

    Injectable anti-migraine drugs are sold between 245 and 270 € depending on the pharmacy. The situation is therefore blocked, since the manufacturers are still not ready to lower their prices as much.

    Consult a GP online

    Migraine is a headache of variable intensity, often recurrent, pulsating and usually unilateral. Pain – on the right or left side of the head – is one of the main symptoms. To reduce it, a few simple steps can be taken:

    • Lie down in a quiet, dark room;
    • Put a cold cloth on his forehead;
    • Drink water to avoid any form of dehydration, especially in case of vomiting.
    • Take painkillers or anti-inflammatories.

    Paracetamol has a very moderate effectiveness on migraine pain, while anti-inflammatories are more effective (ibuprofen, ketoprofen).

    However, they should not be associated with each other, or with aspirin.

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