How individual patients experience migraine and headache disorders varies widely, so having many different treatment options maximizes patients’ ability to better manage their disease. Neuromodulation devices are one drug-free option that can improve patients’ quality of life, particularly for children. Thankfully, access to this non-invasive, drug-free treatment is starting to ease.
An Effective Non-Pharmaceutical Option
Migraine is one of the most common neurological conditions in children. Using a remote electrical neuromodulation – or simply REN – device for migraine is a meaningful advancement, particularly for treatment in adolescents. Currently, there are three noninvasive neuromodulation devices – which target neural pathways to reduce pain frequency and intensity – that are FDA approved for treating acute and preventative migraine.
The REN device has been found to prevent migraine attacks and can also treat symptoms, if they arise. Patients with advanced heart disease or who are pregnant, and others who are concerned about drug interactions, often turn to the REN device as an alternative.
Studies show that 74% of patients who used these devices over 12 months report consistent pain relief, with 26% achieving complete pain freedom. Research has shown REN devices reduce emergency room visits, lost workdays and healthcare costs. Given that migraine symptoms can complicate or impair treatment of other conditions, resolving migraines can improve other conditions, freeing patients to live fuller lives.
Traditionally, obtaining coverage for the market-ready REN device has been challenging, often due to insurers’ confusion about the device’s technology and its misclassification as transcutaneous electrical nerve stimulation, a different non-drug option for migraine management. But in recent years, more health plans have expanded their coverage for this REN device; they should be commended for their stance on wearable neuromodulation devices.
Advocates Aim to Expand Coverage
Several Medicaid programs now include coverage for a REN device, including those in Arizona, Colorado, the District of Columbia, New Jersey, Ohio and Virginia. Highmark Inc. has also added commercial coverage and the Veterans Health Administration has recognizes the benefits, covering neuromodulation devices for veterans and reporting notable improvements in pain levels and functionality. While these decisions mark a shift toward improved access to non-drug treatment options, access remains inconsistent.
Policymakers and advocates play a crucial role in the quest to expand coverage.
The Headache & Migraine Policy Forum called on Elevance Health and Blue Cross Blue Shield to extend coverage to more states. The former has confirmed it is considering coverage but has not made a final decision. Advocates are also urging public insurers, including Texas Medicaid, to follow the lead of other states by including neuromodulation devices in its formulary.
Keeping students in school and employees at work has economic and social benefits beyond individual health outcomes; however, an improved quality of life remains a top priority for the millions of Americans who are affected by migraine. Consistent advocacy for better coverage and greater awareness are essential to ensuring more individuals can access this effective, non-drug treatment.
