Session 6 - Nordic reimbursement guidelines for aCGRP treatment

Marja-Liisa Sumelahti

MD, PhD, Specialist in Neurology, Faculty of Medicine and Health Technology, Tampere University, Finland

The Finland national health insurance scheme (KELA) reimburses patients at 40% of the cost of erenumab, fremanezumab and galcanezumab. Eligibility is determined by statements from a neurologist (the first and the second statement) or a physician having experience in migraine treatment (the third statement). Eligible patients must have at least 8 migraine days a month on average during a 3-month period with at least two preventive medications proving unsuccessful due to lack of effectiveness or they are not tolerated or they are contraindicated.

The statement procedure has two steps. After the first statement, the patient must achieve a ≥50% reduction in monthly migraine days over a 12-week period during the first 6 months. The response has to be evaluated at weeks 9-12. The second statement has to be submitted if the response is achieved and then the reimbursement will be continued for a further 2 years. A third statement is then granted if the improvement in monthly migraine days was sustained for the 2-year period. The first two statements must be made by a neurologist but any physician can make the third statement.