CCA Press Release: Increasing access to migraine treatments in primary care

Pharmacy First headache pathway could transform care for patients facing second leading cause of disability  

A new report by the Company Chemists’ Association (CCA) calls on the government to expand Pharmacy First to include a clinical pathway for acute headaches and migraines.

Read the CCA’s report

The CCA’s latest analysis, which was carried out as part of a collaborative working initiative with Pfizer UK, shows that up to 1.25 million people with acute headaches and migraines could be supported through community pharmacies. This would give people faster access to effective treatment, helping them to return to work quicker, whilst also easing pressures on GPs and hospitals.

The pressure and cost of migraine and headaches on the NHS and wider society are significant:

• Every year, around 2.5 million¹ primary care appointments in England relate to headaches, with 100,000 patients referred for hospital care.²
• In the last six years, A&E has seen a 313% increase in headache presentations³. Delays in accessing appropriate care mean many patients struggle to obtain timely treatment in primary care or specialist clinics. This often results in worsening symptoms and avoidable referrals.
• In 2020 alone, direct NHS costs for headache treatment reached £250 million,⁴ and migraines cost the wider economy an estimated £12 billion⁵ in lost productivity and tax revenue.

Headaches and migraines are among the most common and debilitating conditions in the UK. Migraines affect 14% of the population⁶ and headaches are now the second leading cause of disability.⁷

Community pharmacies are already delivering high-quality treatment for a range of common conditions through Pharmacy First. Pharmacists possess the clinical skills required to assess and support patients with acute headaches and migraines.

Expansion of Pharmacy First would deliver benefits for patients, employers, and the wider NHS. It would:

• Every year allow up to 1.25 million people to have accessible treatment closer to home from their community pharmacy.
• Enable quicker access to care, and effective treatment would allow people to recover sooner and return to work faster.
• Improve equity of access, particularly in areas of high deprivation, where there is a higher proportion of pharmacies.
• Reduce pressure on A&E, general practice, and hospitals by preventing deterioration and reducing the need for onwards referrals.
• Support the Government’s objective of shifting more care into community settings.

We are calling on the government to expand Pharmacy First to include a clinical pathway for migraine and headaches. This expansion would not only ensure faster care for patients but provides a clear opportunity to reduce pressures on the NHS. It would also help to reduce the £5.8billion⁸ of productivity losses by enabling people to get back to work faster.

This new clinical pathway, within the existing Pharmacy First service, will only be possible however if it is properly funded.  The pharmacy sector is chronically underfunded, and any new activity to relieve pressure elsewhere in the NHS  will need new funding. The NHS’ own economic analysis has shown there is a considerable gap between the cost of delivering NHS pharmaceutical care and the funding currently available to the pharmacy network in England.

CCA Chief Executive, Malcolm Harrison said:

“The current model of support for patients with headaches is placing a huge and growing burden on the NHS, with many patients unable to access timely treatment.

Headaches are the cause of millions of NHS appointments every year and have contributed to sharp increases in A&E attendances. Pharmacists are ready and willing to ease that pressure by supporting up to 1.25 million patients annually through the Pharmacy First service.

With adequate funding, expanding the Pharmacy First service to include acute headaches and migraines would deliver faster, more accessible care for patients. This would help patients get back to their daily lives quicker, while also relieving pressure on the NHS.”

Hetal Naik, Primary Care Lead, Pfizer UK, commented:

“We welcome the publication of this report, which clearly sets out the scale of unmet need in migraine and highlights the opportunity to improve access to care through community pharmacy. With headaches and migraine placing significant pressure on patients, the NHS and the wider economy, there is a clear case for exploring new, community-based approaches to care.

Through Pharmacy First, community pharmacies are already delivering care for a range of common conditions. Building on this established model to include headache and migraine is closely aligned with the NHS 10 Year Health Plan’s ambition to shift care from hospital settings into the community, helping people access appropriate treatment earlier, closer to home, while easing pressure on general practice and emergency services.

At Pfizer UK, we are proud to have supported this collaborative project and welcome continued discussion on how policy, commissioning and partnership can help improve outcomes for people living with migraine.”

ENDS

Read the CCA’s report

Notes to editors

The report, ‘Increasing Access to Migraine Treatments in Primary Care’ was developed as part of a collaborative working project between the CCA and Pfizer UK. It was funded by Pfizer Ltd and is non-promotional. Pfizer reviewed the report for medical accuracy and to ensure compliance with regulations.

How patients with headache and migraine are currently treated

Patients with headaches and migraines are currently managed through self‑care advice and through obtaining over the counter (OTC) treatments from a pharmacy. Those needing additional support are required to book a GP appointment for further care.

Only limited quantities of OTC medicines can be purchased for simple headaches, restricting how effectively people can manage recurring symptoms. For migraines, sumatriptan is available from pharmacies, but regulation caps supply at just two tablets at a time, creating barriers for those who experience repeated or severe attack.

Pharmacy First

Pharmacy First, launched in January 2024, enables community pharmacies to treat patients for seven common conditions following defined clinical pathways.

Methodology

Data from NHS England¹ shows that there are around 2.5 million primary care appointment linked to headaches and migraines every year. Based on experience from other Pharmacy First clinical pathways, we believe up to half of these patients could (and would be willing to) receive treatment from a community pharmacy.

References

1. “NHS England,” 01 January 2020. [Online]. Available: https://www.england.nhs.uk/2020/01/improved-nhs-migrainecare/. [Accessed October 2025].
2. “NHS England,” 01 January 2020. [Online]. Available: https://www.england.nhs.uk/2020/01/improved-nhs-migrainecare/. [Accessed October 2025].
3. NHS England, 25 September 2025. [Online]. Available: https://digital.nhs.uk/data-andinformation/publications/statistical/hospital-accident–emergency-activity/2024-25. [Accessed October 2025].
4. Martins et al., “The Hidden Economic Consequences of Migraine to the UK Government: Burden-of-Disease Analysis Using a Fiscal Framework,” Journal of health economics and outcomes research, vol. 10, no. 2, pp. 72-81, 2023.
5. Martins et al., “The Hidden Economic Consequences of Migraine to the UK Government: Burden-of-Disease Analysis Using a Fiscal Framework,” Journal of health economics and outcomes research, vol. 10, no. 2, pp. 72-81, 2023.
6. Martins et al., “The Hidden Economic Consequences of Migraine to the UK Government: Burden-of-Disease Analysis Using a Fiscal Framework,” Journal of health economics and outcomes research, vol. 10, no. 2, pp. 72-81, 2023.
7. Lancaster University, April 2018. [Online]. Available: https://www.lancaster.ac.uk/media/lancaster-university/contentassets/documents/lums/work-foundation/SocietysHeadacheTheSocioeconomicimpactofmigraine.pdf. [Accessed October 2025].
8. Martins et al., “The Hidden Economic Consequences of Migraine to the UK Government: Burden-of-Disease Analysis Using a Fiscal Framework,” Journal of health economics and outcomes research, vol. 10, no. 2, pp. 72-81, 2023.