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The number one prescriber to migraine patients are migraine patients. This is because the majority of migraine patients do not see any physician. In fact, only a small majority of migraine patients have even received the diagnosis of migraine from any physician even if they consulted a physician for their headache. Many are misdiagnosed with tension headache or recurrent sinus headaches. A recent study suggests that patients with moderate to severe recurrent sinus headaches actually suffer from migraine. Neurologist only see a small percentage of overall migraine patients.

Many migraine patients have seen a physician in the past but do not currently see any physician. When asked why, these patients commonly state that lack of effective treatment as the number one reason. Many physicians, unfortunately, practice a form of prescribing for migraines known as step care. In this system, the cheapest medications are prescribed first and the newer, more expensive medications are prescribed only if the patient returns and states the older medications did not work. While the less expensive medications may cost less, the ultimate cost to an average individual is actually higher than the more expensive medications. In fact, the newer agents have been shown to be cost effective and result in higher levels of patient satisfaction compared to prior therapies.