{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T08:12:43Z","timestamp":1776759163562,"version":"3.51.2"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This paper provides a critical review of the decision\u2010making process of the Ontario Ministry of Health and Long\u2010Term Care (MOHLTC) regarding which migraine treatment drugs will be covered under the Ontario Drug Benefit Formulary (ODB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Text<\/jats:title>\n                    <jats:p>Under MOHLTC policy, triptans and OnabotulinumtoxinA are available to patients only through the Exceptional Access Program (EAP). This policy, and justifications for it, are examined with reference to clinical guidelines, patient experiences, and health policy literature. The contexts and consequences of compromised access are outlined. Improvements in access to these treatments are suggested by highlighting how a country with similar healthcare infrastructure \u2013 Australia \u2013 employs policies that more adequately meet the needs of migraine patients as they secure treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite clinically significant gains in the discovery of safe and effective migraine\u2010specific treatments the ODB thus far has failed to align its practice with current clinical recommendations. This forces patients to rely heavily on medication that, while still effective for some, is potentially suboptimal. This review concludes it is prudent, at minimum, to follow clinical recommendations that advocate for the removal of triptans from EAP and recategorize them as Limited Use drugs. Ideally, moving them to a general benefit would further remove the barriers experienced by patients attempting to access this treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.13918","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T18:26:44Z","timestamp":1596652004000},"page":"1888-1900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Access to Migraine Treatments in Ontario, Canada: A Review of the Ontario Drug Benefit Program"],"prefix":"10.1111","volume":"60","author":[{"given":"Susan","family":"Cape","sequence":"first","affiliation":[{"name":"School of Social Work McMaster University Hamilton ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Atlas of Headache Disorders and Resources in the World 2011","author":"Shekhar S","year":"2011"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2017.23.11.1169"},{"key":"e_1_2_13_4_1","first-page":"10","article-title":"Prevelance of migraine in the Canadian household population","volume":"25","author":"Ramage\u2010Morin P","year":"2014","journal-title":"Health Rep"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-018-0846-2"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-019-1027-7"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100010453"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13613"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2003.00599.x"},{"key":"e_1_2_13_10_1","volume-title":"How are Drugs Approved: The Ontario Ministry of Health and Long\u2010Term Care","year":"2016"},{"key":"e_1_2_13_11_1","volume-title":"The International Classification of Headache Disorders 3rd Edition","year":"2018"},{"key":"e_1_2_13_12_1","volume-title":"Get Coverage from Prescription Drugs: Who Can Qualify","year":"2016"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12594"},{"key":"e_1_2_13_14_1","unstructured":"Exceptional Access Program;2016. Available at:http:\/\/health.gov.on.ca\/en\/pro\/programs\/drugs\/eap_mn.aspx. Accessed May 21 2020."},{"key":"e_1_2_13_15_1","unstructured":"How are Drugs Approved: Health Canada;2016. Available at:http:\/\/www.health.gov.on.ca\/en\/public\/programs\/drugs\/approval\/approval_health.aspx. Accessed May 25 2020."},{"key":"e_1_2_13_16_1","unstructured":"Limited Use;2016. Available at:http:\/\/health.gov.on.ca\/en\/pro\/programs\/drugs\/limited_use_mn.aspx. Accessed May 25 2020."},{"key":"e_1_2_13_17_1","volume-title":"How are Drugs Approved: Common Drug Review Ontario Ministry of Health and Long Term Care (MOHLTC)","year":"2016"},{"key":"e_1_2_13_18_1","unstructured":"CADTH Common Drug Review (CDR).CADTH;2019. Available at:https:\/\/www.cadth.ca\/about\u2010cadth\/what\u2010we\u2010do\/products\u2010services\/cdr. 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