Missouri

Medicare Migraine Prescribing Gap Report

84.6%

of primary care physicians actively prescribing triptans to Medicare patients in Missouri have never prescribed a CGRP medication

435gap PCPs
79prescribing CGRPs
514 total active prescribers

How Missouri compares

Missouri84.6%
National average90.4%

Missouri's 84.6% gap is 5.8 points below the national average of 90.4%. 435 of 514 primary care physicians with an active Medicare migraine patient panel have never written a CGRP prescription.

Metro breakdown

CityActive prescribersNever prescribed CGRPGap %
Saint Louis958690.5%
Springfield423890.5%
Kansas City232087%
Columbia181266.7%

About the data

Based on CMS Medicare Part D prescribing data — the only publicly available provider-level prescribing dataset in the United States. Active prescriber = 20+ triptan claims in the observation period. Medicare patients represent a subset of the total migraine population; the true gap is likely larger. Full methodology →

What drives the gap

Prior authorization burden is the primary structural explanation for this gap. The Headache Vault's PA Engine helps primary care physicians navigate CGRP prior authorizations in Missouri and all 50 states — free for all clinicians.

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Citation

Doty A. Migraine Prescribing Gap in Missouri. The Headache Vault; 2026.
Available at: https://headachevault.com/research/prescribing-gap/missouri/
Licensed CC BY 4.0.
Data: CMS Medicare Part D Prescriber Public Use Files, 2022-2023.
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