Behavioral Approaches Beat Meds, for Migraine Treatment

Treating chronic migraines with behavioral approaches – such as relaxation training, hypnosis and biofeedback – can make financial sense, as compared to prescription drug therapies.  Donald Penzien, from the University of Mississippi Medical Center (Mississippi, USA), and colleagues compared the costs over time of several types of behavioral treatments with prescription drug treatments. The researchers didn't compare the effectiveness of methods, nor did they calculate the costs over time of individual drugs, since dosages and prices vary widely. Rather, they figured the per-day costs of each method based on fees of physicians and psychologists. The cost of minimal-contact behavioral treatment, when a patient sees a therapist a few times but largely practices the behavioral techniques at home – aided by literature or audio recordings, at the six-month mark was competitive with pharmacologic treatments using drugs costing 50 cents or less a day.  After one year, the minimal-contact method was nearly $500 cheaper than pharmacologic treatment.  The team concludes that: “This analysis suggests that, relative to pharmacologic options, limited format behavioral interventions are cost-competitive in the early phases of treatment and become more cost-efficient as the years of treatment accrue.”