Workforce, Access Challenges Impede Patients’ Ability to Manage Migraines | NCPA 2025

According to Amaal J. Starling, MD, FAAN, FAHS, with approximately 50 million US patients experiencing migraines, there are less than 900 certified headache specialists. On one hand, this significant gap can be detrimental for patients experiencing migraines and the reduced quality of life they accompany. However, this gap also creates an opportunity for pharmacists to step in and manage patients’ migraine medications while counseling them through their conditions.

“After many, many months of wait, we are unable to do frequent follow-ups. The vast majority of my patients I can usually see once every 6 months, and that is even challenging sometimes,” Starling told Drug Topics. “Ideally, I'd like to see them at least every 3 months, and my goodness, wouldn't it be great if there was a touch point every month?”

Starling, a headache specialist, joined us at the National Community Pharmacists Association (NCPA) 2025 Annual Convention & Expo along with her colleague Courtney Hahs, PharmD. Starling is an associate professor of neurology at the Mayo Clinic College of Medicine and Science, while Hahs is a clinical pharmacist at SEMO Rx Pharmacies and SEMO Rx Care Coordination. They joined Drug Topics to discuss both the challenges and opportunities in the migraine and headaches spaces.

In this part of our interview with the duo, Starling first addressed her experience as a headache specialist and how her and her colleagues’ patient populations far outweigh their availability to provide counsel. With such a large gap in migraine care among millions of people not seeking treatment for their conditions, both Starling and Hahs agree there are several opportunities for pharmacists.

Not only have they recognized the gap and see those opportunities, they have even collaborated together to improve migraine care among their patients through pharmacist-led interventions that are surprisingly new to the space.

Read more of our coverage from NCPA 2025.

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