TABLE 3 .

Managed Care Considerations in Migraine Disease ^{30 , 35 , 38 – 41 , 44}

Focus	Considerations
Supporting equitable access to care	• Allow coverage of telehealth visits in accordance with relevant laws. • Advocate for expansion of legislation related to telehealth. • Provide resources to members to address challenges with use of technology. • Ensure the availability of translating services for telehealth visits on promoted platforms. • Continuously review and improve provider networks when possible. • Work with relevant stakeholders such as health care providers and employer groups to increase migraine disease screenings and improve quality of care. • Work with health care provider partners to provide education on migraine disease and its treatments when appropriate • Work with drug development partners to improve representation of minority and vulnerable groups in research and evidence generation.
Managing treatments for migraine disease	Coverage policy—The coverage determination process should be clear and efficient. The following criteria elements may be considered: • Appropriate patient population • Diagnosis • Ability to use other treatment options (eg, drug-drug interactions) • Other patient-specific factors (eg, route of administration needs, impact of tolerability on adherence) • Specialist consultation requirement • Allowing concomitant use • Coverage renewal parameters • Align pharmacy and medical policies (eg, onabotulinumtoxinA) Preferred medications/step therapy—Consider guideline recommendations such as from the American Headache Society and American College of Physicians. Quantity limits—Consider prescribing information maximum dosages and risks of medication overuse headache and chronification with acute treatments. Value-based arrangement—Consider outcomes-based contracts for newer or more costly medications to ensure cost-effective use. Nonpharmacologic treatments—Consider strategies to encourage appropriate use including coverage when applicable.