Election 2022: let’s make migraine count

This has been a pretty frustrating election so far, with a lot of nonsense and very little substance. We always had a fight to get migraine on to the agenda, and in this kind of environment we have to fight even harder – so my friends, it’s time to get LOUD. We have to make it clear that migraine counts, and if they want our votes then they need to start talking about migraine.

Let’s start with what we’ve heard in the campaign so far.

There’s been bi-partisan commitment to lower the co-pay for PBS listed medicines for people that don’t have concession card. Liberal/National Coalition will drop the maximum to $32.50, Labor to $30. For people with migraine who often have multiple meds – and especially everyone on Emgality and Ajovy paying that maximum co-pay – that’s good news.

What’s not being said is that all of the blah blah about making the PBS meds cheaper has not done a damn thing for people on concession cards. We’re still paying $6.80 a script.

Additionally, none of that fixes the structural problems we have in migraine land, like for example triptans only coming in packs of four tablets, meaning many of us – even with concession cards – are paying way more than $30 a month because of a pack size limit that makes no sense whatsoever. That pack size limit is purely a creation of PBAC guidance given way back when triptans were first listed, and the cost of developing a new pack and bringing it to market, getting TGA and PBAC approval and negotiating for PBS listing being way too high for any company. And, the subject closest to my heart, it does nothing to get the medications not on the PBS, like Aimovig, or even some of the really silly ones like 100mg Topiramate or Ondansetron – both cheap generics, available for others but not for us – onto the PBS.

The Government did lower the safety net threshold in the budget already – if you don’t know what that is or how it works chat to your pharmacist, but basically once you spend a certain dollar amount on PBS listed medications, you pay nothing (if you’re on a concession card) or the concession amount of $6.80 for the rest of the year. The Liberals also announced they will extend access to the Seniors health card entitlement for self funded retirees, which is great if that applies to you.

The 50 Urgent Care centres announced by Labor will also be good news – if you’re lucky enough to be near one of them. Urgent Care is a really important part of migraine management around the world, as dealing with migraine crisis does require urgent attention, but doesn’t require the full resources of an emergency room – quiet room, good drugs, maybe fluids and oxygen, maybe CT or MRI to rule out a stroke if there are hemiplegic symptoms is all we need. It remains a long term dream of mine to a have migraine crisis centres established with migraine nurse practitioners to look after us, without the shame and stigma we usually get of being treated like drug seekers who are wasting emergency’s time… perhaps if these centres go well we can build on them with a quiet room and a migraine NP training program.

Unfortunately, it looks like none of the 50 centres will be in rural Australia (sorry Albo, Cessnock is not ‘rural’ in my world, it’s basically an outer suburb of Newcastle, but nice try). The intense doctor shortage in many rural areas continues to be a huge problem for all rural Australians, but particularly those with chronic illness, as we need to see our doctors often and simply can’t get the appointments. I haven’t heard any serious proposals for what will be done to address this issue, or to get more specialist access in rural areas. There’s been some murmuring about ‘looking at ways’ to further incentivise bulkbilling in rural areas, which in my opinion is to fundamentally not understand the issue.

What will help all of us is restored access to telehealth counselling and psychiatric care – a Labor commitment to do that seems a bit thin, but I’ll take it.

Most of the other announcements are about hospital funding and, as per usual, cancer, cancer, cancer. I’m so bored by cancer funding. No offence to cancer advocates – cancer’s a very scary thing, I’ve had it – but it’s nothing compared to the long grind of severe chronic illness in either its capacity to debilitate a person or the burden on the economy. I’m really looking forward to the day when we have politicians with the bravery to see the entire health board and talk about something other than medicare rebates, hospital beds, and cancer.

Actual announcements or even mentions of migraine so far? Zero.

Do better.

You read Migraine Australia’s guide on how to ask your candidate what they plan to do about migraine here. https://www.migraine.org.au/pollieguide