Abstract:

Background: Migraine represents a significant neurological disorder affecting approximately 11.5% of the European population, with substantial personal, economic, and healthcare system impacts. Recent advances in migraine pathophysiology understanding, particularly the role of calcitonin gene-related peptide (CGRP), have revolutionized treatment approaches.

Objective: To provide a comprehensive analysis of current migraine treatment options available to patients across European healthcare systems, evaluate emerging therapeutic evidence, and identify healthcare access disparities and optimization opportunities.

Methods: This comprehensive review synthesized evidence from recent systematic reviews, meta-analyses, and clinical guidelines published between 2020-2025, including the 2024 International Headache Society recommendations, 2025 European epidemiological data, and national healthcare policy documents. Data sources included PubMed, Cochrane Library, European Medicines Agency reports, and national health authority guidelines.

Results: Current evidence demonstrates significant advances in migraine management, with CGRP-targeted therapies now recommended as first-line preventive treatments for episodic migraine with moderate disability. European prevalence varies from 9.7% (Germany) to 14.0% (Spain), with 56.1% of patients experiencing disability. Treatment satisfaction remains suboptimal, with less than 50% of patients reporting high satisfaction with current therapies. Healthcare access disparities exist across European countries, particularly for novel CGRP inhibitors, with reimbursement criteria varying significantly between nations.

Conclusions: While therapeutic options for migraine have expanded substantially, significant opportunities exist to optimize patient care through improved access to evidence-based treatments, standardized reimbursement criteria, and enhanced healthcare provider education. The shift toward CGRP-targeted therapies as first-line treatments represents a paradigm change requiring healthcare system adaptation across Europe.

Keywords:

MIGRAINE, CGRP INHIBITORS, EUROPEAN HEALTHCARE, TREATMENT ACCESS, SYSTEMATIC REVIEW, <br /> HEALTHCARE DISPARITIES, NEUROLOGICAL DISORDERS, PREVENTIVE THERAPY, TRIPTANS, HEALTHCARE POLICY