Institute pays for study on which migraine drugs really work

The fund is also using its $3.22-per-life fee to back studies on care effectiveness for other conditions, such as kidney stones and anxiety.

Credit: VP Photo Studio/Shutterstock

The Patient-Centered Outcomes Research Institute is backing a study of interest to any employers that are paying for care for workers or dependents who suffer from chronic headaches: Which drugs really work best at preventing and controlling headaches?

Does requiring patients with migraine to use step therapy, by starting with older, inexpensive drugs, then moving to newer, more expensive drugs if the cheaper drugs fail, really save money?

PCORI awarded a $12.6 million grant to Dr. Todd Schwedt, a researcher at Mayo Clinic Arizona, to test three different migraine prevention medications on 1,200 adults. Schwedt and colleagues will then see what percentage of the patients have a 50% or greater reduction in headache frequency at weeks 9 to 12 after starting to take the medication.

PCORI included the Schwedt grant in a $165 million wave of care effectiveness research grants it awarded to researchers earlier this week.

In addition to the Schwedt migraine treatment comparison study, the new wave of PCORI-backed studies will include researchers on matters such as the best treatments for kidney stones, how well telerehabilitation works for patients with chronic low back pain, and strategies for children with mild pneumonia outside of hospitals.

PCORI was created by the Affordable Care Act and calls itself an independent nonprofit research organization. It uses an annual per-enrollee fee imposed on almost every kind of health coverage arrangement, including fully insured group health plans and self-insured employer health plans, to pay for treatment effectiveness research.

The cost of care cannot be the primary focus of a study PCORI funds, but PCORI-backed researchers are supposed to gather as much information as they can about any matters of importance to the patients, including pain, inconvenience and cost, while comparing how well different treatments work.

Related: Compliance update: New 2022 reporting requirements

The PCORI fee for federal fiscal year 2024, which ends Sept. 30, is $3.22 per covered life and was due July 31.

Congress added the PCORI provision to the Affordable Care Act in response to complaints that too little medical research focuses on what works in the real world.

PCORI has awarded a total of $4.5 billion in grants since it came to life, in 2010.

PCORI posts descriptions of each project funded on its website.

One 2022 study found, for example, that mindfulness-based stress reduction seemed to work about as well for many patients suffering from anxiety as well as a popular anxiety drug, according to a project status page.

PCORI also includes a discussion about how peer reviewers responded to the study and how the researchers addressed peer reviewers’ questions about the results.