Although many medications may seem alike, in the management of chronic conditions, it’s crucial to have access to a broad selection of treatment options to achieve the most favourable outcomes for patients, since each medication can serve a distinct and important purpose for different individuals, according to Dr. Elizabeth Leroux, a faculty lecturer at McGill University.
During a session supported by Lundbeck at Benefits Canada’s 2025 Face to Face Drug Plan Management Forum, she likened this to Allen keys. “They all look alike, but if you need key No. 4, having No. 2 and No. 6 is completely useless.”
Migraine isn’t just a headache, she added, it’s a spectrum disorder with significant impacts on quality of life and productivity. According to the World Health Organization, migraine is the most frequent neurological disease.
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Advances in genetics and neuroscience have led to a deeper understanding of migraine, said Leroux, culminating in the development of a new class of treatments known as calcitonin gene-related peptide inhibitors, she said, noting these medications have been described as the CGRP blockade, a breakthrough offering improved effectiveness and tolerability.
CGRP blockers, which are strongly recommended by the Canadian Headache Society, have helped some patients experience nearly complete control of their migraine, she said, which is an outcome that was previously unheard of.
Despite these advances, there’s no cure for migraine. Instead, the hope is migraine freedom, which Leroux described as a patient’s life being free from the massive impact of attacks.
Not all patients respond to the first medication they try, she added, and some may experience side-effects. In these cases, physicians must be able to switch treatments, sometimes trying several options before finding the most effective one. This process doesn’t necessarily increase costs, noted Leroux, since patients will discontinue ineffective medications in favour of those that work better for them.
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Despite these treatment advances, access remains a challenge, she noted. Unfortunately, some payers mistakenly believe that once a patient’s migraine are controlled, treatment can be stopped. This approach would never be considered for other chronic conditions like epilepsy, hypertension or diabetes, said Leroux, questioning why migraine should be treated differently.
Finally, she recommended that continued access to a full range of treatment options is vital for maintaining patient health and quality of life.
Read more coverage of the 2025 Face to Face Drug Plan Management Forum.